Abstract
Guillain-Barré syndrome (GBS) is a clinical entity characterized by acute onset and paralyzing inflammatory peripheral nerve involvement. Plasma exchange (PE) and intravenous immunoglobulin (IVIg) have been recommended to date as treatment modalities for GBS, and the efficacy of these two treatments was reported to be equivocal in patients without renal failure. Since the incidence of GBS in hemodialysis patients is rare, the therapeutic recommendation for GBS in patients with renal failure has not yet been established. We encountered 4 hemodialysis patients complicated by GBS. In 2 of these patients, we initially administered IVIg, but there was no beneficial effect was observed. Therefore, we performed PE on these patients. A remarkable improvement on their muscular strength was observed immediately after PE. We selected PE as the first line of treatment for GBS based on these experiences. Therefore, the subsequent 2 patients were initially treated with PE and the results were successful. We conclude that PE is better than IVIg for the patients with renal failure.
