Is a second cycle of immunoglobulin justified in axonal forms of Guillain-Barré syndrome?

Daniel Agustin Godoy, Alejandro Rabinstein

Research output: Contribution to journalArticlepeer-review

10 Scopus citations


Objective: In certain situations, severe forms of Guillain-Barré syndrome (GBS) show no response or continue to deteriorate after intravenous immunoglobulin (IVIg) infusion. It is unclear what the best treatment option would be in these circumstances. Method: This is a case report on patients with severe axonal GBS in whom a second cycle of IVIg was used. Results: Three patients on mechanical ventilation who presented axonal variants of GBS, with autonomic dysfunction, bulbar impairment and Erasmus score > 6, showed no improvement after IVIg infusion of 400 mg/kg/d for 5 days. After 6 weeks, we started a second cycle of IVIg using the same doses and regimen as in the previous one. On average, 5 days after the second infusion, all the patients were weaned off mechanical ventilation and showed resolution of their blood pressure and heart rate fluctuations. Conclusions: A second cycle of IVIg may be an option for treating severe forms of GBS.

Original languageEnglish (US)
Pages (from-to)848-851
Number of pages4
JournalArquivos de neuro-psiquiatria
Issue number10
StatePublished - Oct 2015


  • Acute inflammatory demyelinating polyradiculoneuropathy
  • Flaccid acute paralysis
  • Guillain-Barré syndrome
  • Immunoglobulin
  • Immunotherapy

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology
  • Biological Psychiatry


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