THE COMPARISON OF TWO TYPES OF TREATMENT (HIGH DOSE AND LOW DOSE IVIG) IN CHILDREN WITH GBS IN MOFID HOSPITAL

Objectives: Introduction: Acute inflammatory demyelinating peripheral neuropathy (Guillain-Barre-Syndrome) is the most common cause of immune –mediated peripheral nerve disease in children and with the near disappearance of poliomyelitis, is responsible for the great majority of cases of acute flaccid paralysis. Several controlled studies have done with corticosteroids, plasma pheresis and IVIG in pediatric patients. IVIG treatment is safer and less traumatic in children. IVIG can be done in two types of treatment: 1- High dose that means 1gr/kg/day for 2 days. 2- Low dose that means 400mg/kg/day for 5 days. Several studies in other countries have shown faster rate of recovery in patients who received total dose of IVIG in 2 days as opposed to 5 days.

Methods: Because we have not any study about this two types of treatment in IRAN we decided to compare this two types of IVIG treatment. So the patients that referred to Mofid children hospital for weakness and we diagnosed GBS with history, physical examination, laboratories and EMG-NCV are divided in two groups: 1-High dose IVIG treatment (experimental group) 2-Low dose IVIG treatment (control group) Then the results evaluated.

Results: Our findings showed, in high dose IVIG therapy we have faster rate of recovery than low dose IVIG therapy. In the group of high dose IVIG therapy, lower and upper extremities weakness decreased in time and returning of deep tendon reflex was faster than control group. We have not found any relationship between drug side effects and type of treatment.

Conclusion: Because, in high dose IVIG therapy the patients cure faster so the Hospital stay is shorter than low dose IVIG therapy and complications decreased in them. Because the relationship between high dose IVIG therapy and drug side effects was not significant, so we report high dose IVIG treatment is the choice of treatment for Gullian Barre syndrome.