Prognostic factors of Guillain-Barré syndrome after intravenous immunoglobulin or plasma exchange

Abstract

Objective: To determine the influence of clinical, laboratory, and electrodiagnostic factors on the prognosis of Guillain-Barré syndrome (GBS). Background: Identification of prognostic factors may lead to better selection of patients with a poor prognosis for new therapeutic trials. Methods: The authors studied 147 patients with GBS who participated in the Dutch GBS trial comparing the effect of IV immunoglobulins with plasma exchange (PE). Outcome was measured at 8 weeks because half of the patients had recovered independent locomotion by then and at 6 months, the endpoint of the study. Results: Multivariate logistic regression revealed the following factors predicting outcome (inability to walk independently) at 8 weeks: a preceding gastrointestinal illness (yes, no), age (≥50, Conclusions: The main predictors of outcome in GBS are clinical factors. Diarrhea is an important poor predictor of outcome, especially for the PE-treated group, and a recent CMV infection predicts delayed early recovery.