Immunotherapy for Guillain-Barré syndrome

As the immune system produces antibodies to fight Guillain-Barré syndrome (GBS), it also produces antibodies that attack and damage the covering of the nerves (myelin sheath). For this reason, you may be treated with immunotherapy, which is designed to alter or combat the abnormal immune response by removing the antibodies that are attacking your body.

Two types of immunotherapy may be used to treat GBS:

• Plasma exchange, or plasmapheresis, is a procedure in which the liquid portion (plasma) of your blood is separated from the red and white blood cells and replaced with a saltwater (saline) and albumin (protein) solution. It removes antibodies and other potentially harmful factors from the bloodstream. Plasma exchange requires access to large veins, which may not be possible in some people, and it may be risky in older people or in some people who have heart disease.
• Intravenous immune globulin (IVIG) is a medication often used to boost the body's immune system and make it better able to fight disease. Immune globulin (also called gamma globulin) is a protein in human blood. These proteins are antibodies, which help the body's immune system recognize and destroy foreign substances, such as bacteria and viruses. Because immune globulin is made from donated blood fluids, it is sometimes in short supply and may not be available everywhere.

One of these treatments is often started immediately after you have been diagnosed with GBS that is getting worse. Early treatment may reduce your recovery time.

Plasma exchange and IVIG appear to be equally effective when given early in the course of the disease. They also have similar costs. The choice between one or the other treatment may depend on what is available and most practical.