The acute phase reactant, fibrinogen, as a guide to plasma exchange therapy for acute Guillain-Barré syndrome
| Autor: | Donata Sodano, Rashmi Sanjay, Robert Weinstein, Kenneth C. Gorson, Janice Flanagan, Allan H. Ropper |
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| Rok vydání: | 2005 |
| Předmět: |
Adult
Male medicine.medical_specialty Diagnostic Techniques Neurological Reference range Fibrinogen Guillain-Barre Syndrome Gastroenterology Fibrinogen levels Internal medicine medicine Humans In patient Aged Retrospective Studies Aged 80 and over Guillain-Barre syndrome Plasma Exchange business.industry Acute-phase protein Hematology General Medicine Middle Aged medicine.disease Surgery Apheresis Treatment Outcome Acute Disease Female business Acute inflammatory disorder medicine.drug Acute-Phase Proteins |
| Zdroj: | Journal of clinical apheresis. 21(2) |
| ISSN: | 0733-2459 |
| Popis: | The Guillian Barre syndrome is an acute inflammatory disorder for which plasma exchange is effective treatment. Up to 10% relapse after plasma exchange suggesting that treatment sometimes finishes before disease activity has resolved. We studied whether plasma fibrinogen, an inflammatory marker, might be used to determine when to discontinue plasma exchange in patients with acute Guillain-Barre syndrome. We conducted a post-hoc analysis of apheresis database and hospital records of patients treated with plasma exchange for acute Guillain-Barre syndrome during 1999–2004. Data were analyzed from 28 patients who underwent a total of 29 courses of plasma exchange for acute Guillain-Barre syndrome. The mean (±SD) plasma fibrinogen concentration was 422.5 (±96.4) mg/dl at the time of presentation and, in 17 of the 29, it was above 400 mg/dl (reference range 200–400). Twenty of the 21 patients whose fibrinogen fell by more than 30% from baseline by the time of the final plasma exchange treatment had neurological improvement. There was improvement in only 3 of the 8 instances where fibrinogen decreased by less than 30% by the end of plasma exchange therapy. A ≥30% decrease in fibrinogen by the conclusion of plasma exchange was significantly associated with sustained neurological improvement (P = 0.0025). The plasma fibrinogen level appears to reflect disease activity in acute Guillain-Barre syndrome. A |
| Databáze: | OpenAIRE |
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