Cochrane Summaries

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Intravenous immunoglobulin for Guillain-Barré syndrome

Hughes RAC, Swan AV, van Doorn PA
Published Online: 
11 July 2012

Guillain-Barré syndrome (GBS) is an uncommon disease of the peripheral nerves. It causes weakness, numbness and breathing difficulty. Another Cochrane review has shown that plasma exchange (PE) (taking blood from one vein, separating the plasma from the blood cells and then returning the blood cells with a plasma substitute into another vein) is more effective than supportive care alone. We found seven trials that compared intravenous immunoglobulin (IVIg) (antibodies that have been purified from donated blood) with PE in 623 severely affected participants. In adults, moderate quality evidence shows that receiving IVIg speeds recovery from severe GBS as much as PE. IVIg is slightly safer and much easier to give than PE. According to moderate quality evidence from one trial with 249 participants, IVIg added to PE is not significantly more effective than either alone. Low quality evidence suggests that IVIg is also beneficial in children. More research is needed to determine the best dose in adults and children.