Therapeutic Plasma Exchange in Guillain Barre Syndrome: An experience of Bangabanhu Sheikh Mujib Medical University, Bangladesh

Atiar Rahman,Jannatul Ferdous,Ashraful Hoque,Sheikh Saiful Islam

doi:10.24018/ejmed.2022.4.1.937

Abstract

Background: Therapeutic plasma exchange (TPE) has been used as one of the treatment modalities of neurological diseases. Intravenous Immunoglobulin (IVIG) and Therapeutic Plasma Exchange (TPE)are treatment options in Guillain Barre syndrome (GBS). In developing countries IVIG is not easily available and it is also expensive, TPE is preferred for treatment of GBS as it is affordable. Study on TPE for GBS are scarce here. Most of the study regarding TPE in GBS has been conducted in high –income countries as it is expensive treatment modality. Reports on TPE in GBS is very scared from Bangladesh. Materials and Methods: A retrospective analysis of TPE with a standard hemolysis equipment for the treatment of Guillain Barre syndrome (GBS) was conducted A 50 patients of GBS who received TPE conducted between January 2017 to December 2018 in the department of Transfusion Medicine, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh were analyzed. All patients had underdone at least 2 cycles of plasma exchange. Volume exchanged in each cycle was one plasma volume. Results: Out of 50 cases there were 43 (86%) male and 7 (14%) female. Age range of patients was from 11 – 50 years. Approximately 40% improved clinically of first cycle of PE & 85% after second cycle, 95% after third cycle and 95-100% after 5 cycle. 1(2%) patient died, and 49(98%) patients survived and recovered. Conclusion: The treatment is cost affection in Compassion to IVIG. TPE is and affection, safe and affordable treatment modality for GBS.

Highlights

Guillain Barre syndrome (GBS) is sub-acute inflammatory demyelinating polyneuropathy may be succeeded to sever quadriparesis & respiratory failure which may require ventilation
GBS is an autoimmune disease of the peripheral nervous system
Therapeutic plasma exchange (TPE) in 50 GBS patients having age between 11-50 years was performed in Department of Transfusion Medicine, Bangabandhu Sheikh Mujib Medical University, Shahbag, Dhaka, Bangladesh during January 2017 to December 2018

Summary

Introduction

Guillain Barre syndrome (GBS) is sub-acute inflammatory demyelinating polyneuropathy may be succeeded to sever quadriparesis & respiratory failure which may require ventilation. One third of the patients with GBS will require mechanical ventilation and most GBS related death is due to respiratory failure [3]. Therapeutic plasma exchange (TPE) has been used as one of the treatment modalities of neurological diseases. Intravenous Immunoglobulin (IVIG) and Therapeutic Plasma Exchange (TPE)are treatment options in Guillain Barre syndrome (GBS). In developing countries IVIG is not available and it is expensive, TPE is preferred for treatment of GBS as it is affordable. Study on TPE for GBS are scarce here. Most of the study regarding TPE in GBS has been conducted in high –income countries as it is expensive treatment modality. Reports on TPE in GBS is very scared from Bangladesh

Methods

Results

Discussion

Conclusion