Hirai K, Kihara M, Nakajima F, Miyanomae Y, Yoshioka H
Division of Pediatrics, Social Insurance Kyoto Hospital, Japan.
Pediatr Neurol. 1998 Jul;19(1):55-7. doi: 10.1016/s0887-8994(98)00010-1.
A 12-year-old boy rapidly developed Guillain-Barré syndrome (GBS) after Campylobacter jejuni enteritis. Electrophysiologic studies suggested that demyelination was dominant, and serum anti-C. jejuni and both IgG and IgM anti-GM1 antibodies were significantly elevated. The patient was treated three times with immunoadsorption therapy using a tryptophan-immobilized column. The volume of treated plasma in each session was about 2 L. His blood pressure was maintained within normal range with the use of 5% albumin preparations and etilefrine hydrochloride. His clinical and electrophysiologic findings began to recover shortly after therapy, with a decrease in the levels of serum IgG and IgM anti-GM1 antibodies. This immunoadsorption therapy should be considered for anti-GM1 antibody-associated GBS.
一名12岁男孩在空肠弯曲菌肠炎后迅速发展为吉兰-巴雷综合征(GBS)。电生理研究表明脱髓鞘占主导,血清抗空肠弯曲菌抗体以及IgG和IgM抗GM1抗体均显著升高。该患者使用固定色氨酸柱进行了3次免疫吸附治疗。每次治疗的血浆量约为2L。通过使用5%白蛋白制剂和盐酸乙苯福林,其血压维持在正常范围内。治疗后不久,他的临床和电生理表现开始恢复,血清IgG和IgM抗GM1抗体水平下降。对于抗GM1抗体相关的GBS,应考虑这种免疫吸附治疗。