Different outcome from different approach of therapy by plasmapheresis and immunotherapy in GBS patients

Abstract

Objective To present different outcome of Guillain Barre Syndrome therapy between plasmapheresis and immunotherapy. Background Plasmapheresis and IVIG Therapy are standard therapy for GBS, but in Indonesia there is not any recorded data to show effectivity of both plasmapheresis and IVIG. Methods Prospective serial case report of 50 GBS patient in Saiful Anwar General Hospital from January 2018 to January 2019, with EMG and LCS analysis as tools to establish the GBS diagnose and GBS disability score parameter for asses the improvement of therapy. Statistical method using t paired test. Results 50 consecutive patients were included in the study and consist of 32 men and 18 women. 1 patient was died at ER. Mean age was 40.5 years, mean of hospitalization was 15 days. Types of GBS were divide in 3 type; AMAN in 36%, AMSAN in 46% and SMF in 14%. Plasmapheresis as therapy was in 79% of patient, immunotherapy was 12% and the rest patient was refused to therapy and got supportive therapy. Disability score were assessed at admission, discharge and 6 months follow up. Mean disability score from GBS onset in hospital admission was 4.1. Plasmapheresis shown 60% better outcome in our patients but IVIG only shown approximately 30%. Conclusion Plasmapheresis shown better outcome than IVIG in GBS treatment.