Zusammenfassung
Das Guillain-Barré-Syndrom (GBS) ist diejenige neuroimmunologische Erkrankung, bei der auch nach Kriterien der evidenzbasierten Medizin die gesicherte Indikation für den Einsatz von Immunglobulinen gegeben ist. In mehreren randomisierten und kontrollierten Studien wurde gezeigt, dass IVIg ebenso wie die Plasmaseparation in der Lage sind, den Gesamtverlauf und die Zeit einer etwaigen Respiratorpflicht signifikant zu verkürzen.
Bei der chronischen Variante des GBS, der chronischen inflammatorischen demyelinisierenden Polyneuritis (CIDP) wurden IVIg in mehreren unkontrollierten Studien eingesetzt mit Responderraten zwischen 60 und 80%. In wenigen randomisierten placebokontrollierten Studien waren die Ergebnisse nicht einheitlich. Ein Effekt von IVIg bei der CIDP ist insbesondere dann zu erwarten, wenn die Krankheitsdauer kürzer als ein Jahr ist, eine progrediente Symptomatik bis zum Beginn der Behandlung besteht, sowohl Arme als auch Beine von Paresen betroffen sind, eine Areflexie vorliegt und die motorische Nervenleitgeschwindigkeit des N. medianus verlangsamt ist.
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Berlit, P. (2001). Guillain-Barré-Syndrom (GBS) und chronische inflammatorische demyelinisierende Polyneuritis (CIDP). In: Berlit, P. (eds) Immunglobuline in der klinischen Neurologie. Steinkopff. https://doi.org/10.1007/978-3-642-93716-3_6
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