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Guillain-Barre Syndrome


IVIG and Plasmapheresis

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IVIG: Intravenous Immune Globulin is blood serum from between 3-10,000 blood donors. This blood product is then processed into IgG antibodies. These antibodies may slow or stop the immune system's demyelinating attack caused by autoantibodies in the blood plasma from the autoimmune response of GBS.

The most relevant immuno-modulatory actions of IVIG, operating alone or in combination, are inhibition of complement deposition, neutralization of cytokines, modulation of Fc-receptor-mediated phagocytosis, and down regulation of autoantibody production.


Plasmapheresis: Plasma is the fluid portion of the blood that contains the diseased antibodies attacking other healthy cells in the body (i.e., the myelin and nerves). Plasmapheresis is a process that separates the blood cells; red cells, white cells, and platelets, from the blood plasma so the plasma can be removed. This is accomplished by a device called a blood cell separator, or a centrifuge. The blood cells and platelets are returned to the patient with one of three different type Plasmapheresis or Plasma Exchanges: 1. The patient is given a fluid called Albumin (the same volume of plasma removed and given at the same rate during removal) made of 5-10% blood serum and IV fluids. The body will reproduce new plasma within 24 hours. 2. Fresh frozen plasma (thawed before given, and at the same rate as plasma removed). 3. The patients own plasma can be cleansed through processing and reused. I think this option is rare, however.

Through the Plasmapheresis process, a Plasma Exchange has been made.

Note: This process is now done with temp-ports that allow an inlet and outlet of blood flow, which speeds the time from 5-6 hours to about 2 hours. Blood veins are rarely used.

 

Submitted by Jethro 
20 Jan 2003  

I dimly recall the process, it wasn't painful for me.  I do remember being very cold, though. ~Heath

 

Intra-Venous Immuno-Globulins. (I.V.I.G.)

G.B.S. and C.I.D.P. are neurological illnesses caused by the patient’s own defensive antibodies mistakenly attacking the nerve tissue. Immuno-globulins carrying antibodies are collected from the plasma of many hundreds of blood donors leaving the red cells available for transfusion to other patients.


The Immuno-globulins with antibodies can be infused into the veins of patients with GBS/CIDP to ‘flood’ the bad antibodies of the patient with good ones. This will reduce further damage to the nerve tissue allowing the body to repair the nerves.


Plasma-pheresis

Plasma-pheresis means plasma separation, it is used in the process of plasma exchange.
Plasma is the fluid part of blood, in it are suspended the red and white blood cells and platelets. The patient is linked to the separator from a vein. Blood is drawn into the separator and either centrifuged or filtered. The red and white cells and platelets are returned to the patient with synthetic albumen to replace the plasma. The plasma containing the antibodies, both good and bad, is removed and discarded.. During the procedure Heparin an anti-coagulant is used to stop the blood clotting.


Programs vary, a common one is to have six exchanges on alternate days. Since all antibodies both good and bad are removed, the patient is susceptible to infection for a while after the procedure until new antibodies have been made. During plasma exchange the blood pressure may drop, so patients are monitored. Some may be allergic to synthetic albumen and develop itching, or breathing difficulty.. The requirement for the anti-coagulant may cause some to bleed.

Submitted August 20, 2004 by Dr David B.

 

This page was last modified: July 18, 2006