Original Article Intravenous Immunoglobulin as Therapy for Pediatric Guillain-Barré Syndrome

Seven children with Guillain-Barré syndrome were treated with intravenous immunoglobulin. Median patient age was 5.8 years. A standard dosage of 0.4 g/kg/day for 5 days was administered. Clinical improvement occurred on average within 2.4 ± 1.3 days of beginning intravenous immunoglobulin. One child required mechanical ventilation for 7 days. Eight com-parable children with Guillain-Barré syndrome at our institution in a prior study treated with plasmapheresis alone had similar clinical results. However, the need for admission to the pediatric intensive care unit and duration of pediatric inten-sive care unit stay were lower in the intravenous immunoglobulin treated group (P <.05). There were no complications with intravenous immunoglobulin therapy except for a brief episode of hypotension in one patient. Review of the litera-ture identified 74 additional children with Guillain-Barré syndrome successfully receiving intravenous immunoglobulin therapy. We suggest intravenous immunoglobulin as initial therapy for pediatric Guillain-Barré syndrome, because it appears equally as effective as plasmapheresis and is associated with fewer complications. (J Child Neurol 1997;12:376-380). Intravenous immunoglobulin has been used successfully in the treatment of numerous pediatric diseases, including Kawasaki disease, acquired immunodeficiency syndrome (AIDS), immune deficiency disorders, and idiopathic throm