Neurology
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Figures Only
Right arrow Full Text
Right arrow Correspondence:
Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when Correspondence are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Visser, L. H.
Right arrow Articles by van der Meché, F. G. A.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Visser, L. H.
Right arrow Articles by van der Meché, F. G. A.
Neurology 1999;53:598
© 1999 American Academy of Neurology
Articles

Prognostic factors of Guillain-Barré syndrome after intravenous immunoglobulin or plasma exchange

L. H. Visser, MD, PhD, P. I. M. Schmitz, PhD, J. Meulstee, MD, PhD, P. A. van Doorn, MD, PhD, F. G. A. van der Meché, MD, PhD and for the Dutch Guillain-Barré Study Group

From the Department of Neurology (Drs. Visser, Meulstee, van Doorn, and van der Meché) and Trials and Statistics (Dr. Schmitz), University Hospital Dijkzigt/Dr. Daniel den Hoed Cancer Center and Erasmus University, Rotterdam, the Netherlands.

Address correspondence and reprint requests to Dr. L.H. Visser, Department of Neurology, St. Elisabeth Hospital, Hilvarenbeekseweg 60, Postbus 90151, 5000 LC Tilburg, the Netherlands.

OBJECTIVE: To determine the influence of clinical, laboratory, and electrodiagnostic factors on the prognosis of Guillain-Barré syndrome (GBS).

BACKGROUND: Identification of prognostic factors may lead to better selection of patients with a poor prognosis for new therapeutic trials.

METHODS: The authors studied 147 patients with GBS who participated in the Dutch GBS trial comparing the effect of IV immunoglobulins with plasma exchange (PE). Outcome was measured at 8 weeks because half of the patients had recovered independent locomotion by then and at 6 months, the endpoint of the study.

RESULTS: Multivariate logistic regression revealed the following factors predicting outcome (inability to walk independently) at 8 weeks: a preceding gastrointestinal illness (yes, no), age (>=50, <50 years), Medical Research Council sum score (<40, >=40) at the start of treatment, and—described for the first time—a recent cytomegalovirus (CMV) infection (yes, no). At 6 months, the same clinical factors were found, but an initial rapid progression of weakness also appeared to be a prognostic factor. Analysis of treatment interactions revealed that the effect of diarrhea was more pronounced in the PE-treated group.

CONCLUSIONS: The main predictors of outcome in GBS are clinical factors. Diarrhea is an important poor predictor of outcome, especially for the PE-treated group, and a recent CMV infection predicts delayed early recovery.




This article has been cited by other articles:


Home page
 BMJHome page
J. B Winer
Guillain-Barre syndrome
BMJ, July 17, 2008; 337(jul17_1): a671 - a671.
[Full Text]

Home page
 J. Immunol.Home page
K. Geleijns, A. Roos, J. J. Houwing-Duistermaat, W. van Rijs, A. P. Tio-Gillen, J. D. Laman, P. A. van Doorn, and B. C. Jacobs
Mannose-Binding Lectin Contributes to the Severity of Guillain-Barre Syndrome
J. Immunol., September 15, 2006; 177(6): 4211 - 4217.
[Abstract] [Full Text] [PDF]

Home page
 J. Neurol. Neurosurg. PsychiatryHome page
A Hiraga, M Mori, K Ogawara, S Kojima, T Kanesaka, S Misawa, T Hattori, and S Kuwabara
Recovery patterns and long term prognosis for axonal Guillain-Barre syndrome
J. Neurol. Neurosurg. Psychiatry, May 1, 2005; 76(5): 719 - 722.
[Abstract] [Full Text] [PDF]

Home page
 J Intensive Care MedHome page
M. L. Linenberger and T. H. Price
Use of Cellular and Plasma Apheresis in the Critically Ill Patient: Part II: Clinical Indications and Applications
J Intensive Care Med, March 1, 2005; 20(2): 88 - 103.
[Abstract] [PDF]

Home page
 NeurologyHome page
K. Geleijns, G. M.Th. Schreuder, B. C. Jacobs, K. Sintnicolaas, R. van Koningsveld, J. Meulstee, J. D. Laman, and P. A. van Doorn
HLA class II alleles are not a general susceptibility factor in Guillain-Barre syndrome
Neurology, January 11, 2005; 64(1): 44 - 49.
[Abstract] [Full Text] [PDF]

Home page
 NeurologyHome page
A. Hiraga, M. Mori, K. Ogawara, T. Hattori, and S. Kuwabara
Differences in patterns of progression in demyelinating and axonal Guillain-Barre syndromes
Neurology, August 26, 2003; 61(4): 471 - 474.
[Abstract] [Full Text] [PDF]

Home page
 NeurologyHome page
M. Koga, N. Yuki, K. Hirata, M. Morimatsu, M. Mori, and S. Kuwabara
Anti-GM1 antibody IgG subclass: A clinical recovery predictor in Guillain-Barre syndrome
Neurology, May 13, 2003; 60(9): 1514 - 1518.
[Abstract] [Full Text] [PDF]

Home page
 BrainHome page
C.-L. Pan, T.-J. Tseng, Y.-H. Lin, M.-C. Chiang, W.-M. Lin, and S.-T. Hsieh
Cutaneous innervation in Guillain-Barre syndrome: pathology and clinical correlations
Brain, February 1, 2003; 126(2): 386 - 397.
[Abstract] [Full Text] [PDF]

Home page
 J Child NeurolHome page
Z. Ammache, A. K. Afifi, C. K. Brown, and J. Kimura
Childhood Guillain-Barre Syndrome: Clinical and Electrophysiologic Features Predictive of Outcome
J Child Neurol, July 1, 2001; 16(7): 477 - 483.
[Abstract] [PDF]

Home page
 NeurologyHome page
R.D.M. Hadden, H. Karch, H.-P. Hartung, J. Zielasek, B. Weissbrich, J. Schubert, A. Weishaupt, D.R. Cornblath, A.V. Swan, R.A.C. Hughes, et al.
Preceding infections, immune factors, and outcome in Guillain-Barre syndrome
Neurology, March 27, 2001; 56(6): 758 - 765.
[Abstract] [Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 1999 by AAN Enterprises, Inc.