- No randomized studies performed in children have been published.
One small (n=7) study evaluated the use of intravenous immunoglobulin
in children and compared the results to an earlier study of plasma exchange
(n=8) done at the same institution.4 Their conclusion
was that intravenous immunoglobulin is the preferred therapy.
- It seems that the adult studies should be applicable to children.
However, some investigators have suggested that the course and prognosis
may be more favorable for children with Guillain-Barre syndrome than
- Intravenous immunoglobulin therapy is thought to exert a beneficial
effect by the anti-idiotypic suppression of autoantibodies.1
- Intravenous immunoglobulin therapy has side effects including anaphylactoid
reaction and aseptic meningitis; it is also costly.
- The biggest barrier to further study at the present time is the limited
availability of intravenous immunoglobulin.
- Anonymous. Randomized trial of plasma exchange, intravenous immunoglobulin,
and combined treatments in GuillainBarre syndrome. Plasma Exchange/Sandoglobulin
Guillain-Barre Syndrome Trial Group. Lancet. 349(9407):225-30,
- van der Meche FGA, Schmitz PIM. A randomized trial comparing
intravenous immune globulin and plasma exchange in Guillain-Barre syndrome.
N Engl J Med. 326(17):1123-9, 1992.
- Vajsar J, Sloane A, Wood E, Murphy EG. Plasmapheresis vs intravenous
immunoglobulin treatment in childhood Guillain-Barre syndrome.
Archives of Pediatric & Adolescent Medicine. 148(11):1210-2,
- Abd-Allah SA, Jansen PW, Ashwal S, Perkin RM. Intravenous immunoglobulin
as therapy for pediatric Guillain-Barre syndrome. Journal of
Child Neurology. 12(6):376-80, 1997.