Plasma Exchange Versus Intravenous Immunoglobulin in Children with Guillain Barré Syndrome

Abstract

Objective : To compare the outcome of plasma exchange versus intravenous immunoglobulin among children with Guillain Barre Syndrome.

Methods : A randomized controlled trial was conducted at department of Pediatrics, National Institute of Child Health, Karachi from August 2016 to February 2017. All patients of age ranged from 2-15 years of either gender having duration of Guillain Barre Syndrome not more than 14 days were included. The children were divided into plasma exchange or intravenous immunoglobulin group. Intravenous immunoglobulin was administered for five days in a dose of 0.4 g/kg/day/ while a daily one-volume plasma exchange was given to patients in the plasma exchange group for five days. Duration of mechanical ventilation and the pediatric intensive care unit stay in days were noted.

Results

Of 78 children, the mean age was 6.64 ±3.06 years. There were 47 (60.3%) males and 31 (39.7%) females. A significantly higher length of intensive care unit stay was noted among children who received plasma exchange (9.45 ±4.59 days) as compared to the children who received intravenous immunoglobin (4.97 ±2.84 days) (p-value <0.001, 95% CI -6.23 to -2.73). Similarly, the mean duration of ventilator stay was significantly higher among children who received plasma exchange (7.33 ±3.44 days) as compared to the children who received intravenous immunoglobin (2.01 ±0.01 days) (p-value <0.001, -7.91 to -2.74).

Conclusion : The outcome of intravenous immunoglobin founds better than that of plasma exchange in treating children with Guillain Barre syndrome.