Daniela Maria Palma1*, Andrea Neville Cracchiolo1, Leila Zummo2, Gianluca Lopez2, Daniele Lo Coco2 and Rosa Turrisi3
1Department of Trauma, UOC Intensive Care and Trauma Center, ARNAS Civico, Italy 2Department of Neurology, UOC Neurology and Stroke Unit, ARNAS Civico, Italy 3Department of Transfusion Medicine, UOC Transfusion Medicine, ARNAS Civico, ItalyFulltext PDF
Introduction: Guillain-Barre syndrome is a rare disorder in which our body's immune system attacks nerves determining weakness and tingling of extremities as first symptoms. It can also be associated to respiratory failure and require mechanical ventilation during hospitalization (up to 30% of patients). Nowadays patient’s hyper-reactive immune responses benefits from immunotherapies such as Intravenous Immunoglobulin (IVIg), Therapeutic Plasma Exchange (TPE) and new biological drugs. Case Study: We report our experience with the case of a 64-year-old woman who presented a symmetric progressive flaccid paralysis after a week of mild cold symptoms. The respiratory and neurological symptoms worsened despite immunoglobulin infusions and intensive supportive care. She gradually improved with TPE, but we didn’t respect schedules of the American Society for Apheresis (ASFA) and we decided to extend the number of TPE treatments to sixteen. Conclusion: Although the first case of Guillain-Barre syndrome was described a century ago, there are still many dark sides about its etiology, pathogenesis, clinical variants and therapeutic strategies. Further studies are necessary to find answer too many still unanswered questions. The management of these patients must include a high index of clinical suspicion, a prompt diagnosis and adequate therapy without mistakes.
Guillain-Barre syndrome; Intravenous immunoglobulin; Plasma exchange; Acute motor axonal neuropathy; Acute motor and sensory axonal neuropathy; Miller-Fisher syndrome
Palma DM, Cracchiolo AN, Zummo L, Lopez G, Coco DL, Turrisi R. Plasmapheresis and Guillain–Barré Syndrome: Desperate Therapy for Desperate Patient? A Case Report. Neurol Case Rep. 2022;5(1):1030..