Evidence map›Paper›PMID 39695474›Full record

ArticleBMC pediatrics2024

Management of severe pediatric Guillain-Barré syndrome in a low-income country: efficacy and safety of therapeutic plasma exchange in pediatric patients: a retrospective study.

Tahani Ali, Faihaa Hkima Abou Fakher, Malek Alawir, Abdulsater Allababidi, Aya Sheikh Hasan

Abstract read
In one paragraph

Article in BMC pediatrics, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Trial
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Tahani AliPediatric Hematopoietic Stem Cell Transplant Center, Children's University Hospital, Almazeeh, Damascus, Syria. tahani.ali@damascusuniversity.edu.sy.ORCID http://orcid.org/0000-0001-8103-8518
Faihaa Hkima Abou FakherPediatric Hematopoietic Stem Cell Transplant Center, Children's University Hospital, Almazeeh, Damascus, Syria.ORCID http://orcid.org/0000-0002-0900-9381
Malek AlawirFaculty of Medicine, University of Damascus, Almazeeh Street, Damascus, Syria.ORCID http://orcid.org/0000-0001-6975-3535
Abdulsater AllababidiFaculty of Medicine, University of Damascus, Almazeeh Street, Damascus, Syria.ORCID http://orcid.org/0000-0003-0344-4734
Aya Sheikh HasanFaculty of Medicine, Al-Baath University, Al-Sham Street, Homs, Syria.ORCID http://orcid.org/0000-0003-3617-0290

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundGuillain-Barré syndrome (GBS) is an autoimmune disease that affects the peripheral nervous system leading to motor, sensory, and sometimes autonomic manifestations. Therapeutic plasma exchange (TPE), which involves the selective removal of pathological molecules, such as auto-antibodies, from plasma, has proven to be safe and effective in adults with GBS. However, its application in pediatric patients lacks sufficient evidence. This study aims to evaluate the efficacy and safety of TPE in pediatric patients with severe GBS, in a low-resource setting.

methodsThis is a single-center retrospective study of 36 GBS patients aged between 2 and 13 years. A total of 122 TPE sessions were administered, with a median of four sessions per patient. A human albumin solution was the exchange fluid in all the sessions. Clinical improvement was evaluated through general examination and muscle power assessment using the Medical Research Council (MRC) scale.

resultsAll patients showed clinical improvement upon treatment with TPE. The grade of power in the upper extremities increased from a mean of 1.7 ± 1.1 at the peak of illness to 3.7 ± 0.9 at discharge, indicating an increase of 2.0 ± 1.1 (95% CI, 1.6 to 2.4, p< 0.001). Alternatively, in the lower extremities, it increased from 1.2 ± 1.1 to 2.5 ± 0.8, indicating a significant rise of 1.4 ± 0.8 (95% CI, 1.1 to 1.6, p< 0.001). There was a significant improvement in the cranial, autonomic, and respiratory functions among all patients. Half of the patients were available for follow-up and showed full recovery, with six of them still exhibiting minimal residual deficits. TPE-related complications were mostly mild or moderate, with tachycardia, hypotension, and mild anemia being the most common. However, serious complications occurred in three of the patients, necessitating the discontinuation of the treatment in two of them. There was no mortality related to TPE in this study.

conclusionsTPE shows promise in treating pediatric GBS. In this study, TPE was associated with the recovery of neurological functions, yielding positive outcomes with only minimal residual deficits. However, balancing its benefits with potential risks requires careful clinical judgment and rigorous monitoring to ensure patient safety and optimize outcomes. TPE was a more cost-effective and accessible option than IVIG in this financially restricted, low-income setting.

Indexed as

Guillain-Barre SyndromePlasma ExchangeAdolescentChildChild, PreschoolDeveloping CountriesFemaleHumansMalePovertyRetrospective StudiesTreatment OutcomeEfficacyGuillain-Barré syndromePediatric patientsPlasmapheresisSafetyTherapeutic plasma exchange

Identifiers

PMID39695474
PMCPMC11657456

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.