ABSTRACT
OBJECTIVE: To evaluate the efficacy of early therapeutic plasmapheresis in severely affected patients with Guillain-BarrÚ syndrome (GBS). PATIENTS AND METHOD: Patients between 16 to 70 years of age, with GBS according to NINCDS criteria, in stage > or = 3 of Huges severity score and with less than 7 days of onset of symptoms were admitted for therapeutic plasmapheresis. All patients completed a total of five sessions of plasma exchange every other day using 25 albumin and saline in a 1:1 proportion. Follow-up was performed for 6 months. Friedman and Wilcoxon tests were done to establish differences within groups. RESULTS: A total of 34 patients were admitted to the study. The time span between onset of symptoms and admission to the study was 4 days (median). Fourteen (41) required mechanical ventilation. Clinical progression of the syndrome was observed during the first two sessions of plasma-pheresis. Improvement in motor function by Huges score was observed only after fourth session of plasma exchange (p < 0.05). Two patients did not improve, and one died. CONCLUSIONS: Clinical improvement in GBS during early therapeutic plasmapheresis occurs only after the fourth session of plasma exchange.