Role of Therapeutic Plasma Exchange in Guillain-Barre Syndrome after Allogeneic Hematopoietic Stem Cell Transplant: Report of Two Cases
| Autor: | Serap Kural, Zafer Gulbas, Ferda Korkmaz, Demet Cekdemir, Yesim Ozgurel, Neslihan Tiryaki, Hasan Atilla Ozkan |
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| Rok vydání: | 2021 |
| Předmět: |
Mechanical ventilation
Autoimmune disease medicine.medical_specialty Chemotherapy Guillain-Barre syndrome biology business.industry medicine.medical_treatment medicine.disease Gastroenterology General Biochemistry Genetics and Molecular Biology Refractory Methylprednisolone immune system diseases hemic and lymphatic diseases Internal medicine medicine biology.protein Antibody business Complication medicine.drug |
| Zdroj: | Clinical Laboratory. 67 |
| ISSN: | 1433-6510 |
| Popis: | BACKGROUND Guillain-Barre Syndrome (GBS) is an acute inflammatory polyneuropathy characterized with rapid, progressive, ascending, and symmetrical weakness and areflexia. It is supposed to be an autoimmune disease related with production of antibodies by T lymphocytes activated against antigenic proteins of the peripheral nerves. Guillain-Barre Syndrome occurring after hematopoietic stem cell transplant (HSCT) has been associated with viral infections or toxic effects of chemotherapy. METHODS We report two GBS cases after HSCT treated successfully by means of therapeutic plasma exchange. RESULTS In a total of 257 patients, 2 cases (0.8%) were diagnosed with GBS following HSCT. Allogeneic HSCT was performed and complete remission was achieved. Diagnosis of GBS was established on the 45th and 69th days with respect to clinical, cerebrospinal fluid, and electromyography findings. Patients did not respond to treatment consisting of intravenous immunoglobulins (IVIG) (1 g/kg/day) for 2 days and methylprednisolone (1 g/kg/day). Mechanical ventilation was indicated in one patient due to the involvement of respiratory muscles. Therapeutic plasma exchange resulted in complete recovery in both cases. CONCLUSIONS Guillain-Barre Syndrome is a rare but serious complication, which may occur after HSCT. Increased awareness and early diagnosis are crucial in the management of GBS. First line treatment consists of IVIG and steroids and therapeutic plasma exchange must be considered without delay in refractory cases. |
| Databáze: | OpenAIRE |
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