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March 1988

Limited Relapse in Guillain-Barré Syndrome After Plasma Exchange

Author Affiliations

From the Neurological/Neurosurgical Intensive Care Unit and Blood Transfusion Service, Massachusetts General Hospital, Boston (Drs Ropper and Addison); and the Department of Neurology, University of Michigan Medical Center, Ann Arbor (Dr Albers).

Arch Neurol. 1988;45(3):314-315. doi:10.1001/archneur.1988.00520270096026

• Ten of 94 consecutive patients with acute Guillain-Barré syndrome treated with plasma exchange relapsed after initial improvement. Deterioration occurred five to 42 days after the first series of exchanges, was usually mild, and in eight re-treated patients, responded to a second series of plasma exchanges. None developed chronic inflammatory demyelinating polyneuropathy. The initial exchanges began three to 22 days (mean, 11 days) and ended 14 to 27 days (mean, 19 days) after the onset of illness. The biphasic course in these patients with limited relapses suggests that plasma exchange removes a circulating factor that continues to be active if treatment is stopped too early. Re-treatment with a second, and sometimes a third, series of plasma exchanges may be effective.

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