Observational studyIndian journal of pediatrics2025
Serial Serum Immunoglobulin G Levels and Correlation with Outcomes in Children with Guillain Barre Syndrome.
Observational study in Indian journal of pediatrics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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6 authors.
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Abstract
objectivesGuillain-Barré Syndrome (GBS) has variable severity, inconsistent therapy response, and uncertain recovery. Intravenous immunoglobulins (IVIG) are used to treat this immune-mediated disorder. The authors investigated serial IgG levels and outcomes in IVIG-treated GBS patients.
methodsThis prospective observational study from July 2019 and December 2021 in a tertiary pediatric referral hospital included children ≤12 y with GBS diagnosis. Children with recurrent GBS or chronic neuromuscular disorders were excluded. All patients received IVIG (2 g/kg). Serum IgG levels were measured at enrolment, 2 wk, 4 wk, and 3 mo. IgG levels and change in IgG levels from baseline were correlated with outcome. The authors hypothesize that IgG levels before and after therapy may affect functional status outcomes [Medical Research Council (MRC) sum score, GBS disability score].
resultsSeventy patients, median age 6.5 y, were enrolled. Acute motor axonal neuropathy predominated in nerve conduction studies (n = 46, 66%). Admission, 2 wk, 4 wk, and 3 mo median IgG levels were 10.1, 17.9, 13.0, and 9.9 g/L. At 2 wk, higher IgG levels and increments were associated with better functional status. Higher ΔIgG at 2 wk correlated with a shorter hospital stay (r = -0.381, p = 0.001). Lower levels of IgG (16.01 vs. 20.56, p = 0.006) and ΔIgG (6.83 vs. 10.03, p = 0.041) at 2 wk were associated with inability to walk independently at 3 mo.
conclusionsThe increase in serum IgG after IVIG therapy weakly correlates with GBS outcomes in children. A second IVIG dose for non-responders did not improve outcomes at 3 mo, suggesting unknown factors causing severe disease and poor recovery that need further studies.
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