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TOMMASO PICCOLI

Guillain-Barré Syndrome

  • Authors: Daniela Maria Palma; Andrea Neville Cracchiolo; Leila Zummo; Gianluca Lopez; Daniele Lo Coco; Rosa Turrisi; Alfredo Mazzola; Marco Palmeri; Fabio Genco; Angela Ferruzza; Tommaso Piccoli
  • Publication year: 2022
  • Type: Articolo in rivista
  • OA Link: http://hdl.handle.net/10447/533873

Abstract

Background: Guillain–Barré syndrome is a rare disorder in which our body’s immune system attacks nerves determining weakness and tingling of extremities as first symptoms. It can also be associated to respiratory failure and require mechanical ventilation during hospitalization (up to 30% of patients). Nowadays patient’s hyper-reactive immune responses benefits from immunotherapies such as intravenous immunoglobulin (IVIg), therapeutic plasma exchange (TPE) and new biological drugs. Case Report: We report our experience with the case of a 64-year-old woman who presented a symmetric progressive flaccid paralysis after a week of mild cold symptoms. The respiratory and neurological symptoms worsened despite immunoglobulin infusions and intensive supportive care. She gradually improved with TPE, but we didn’t respect schedules of the American Society for Apheresis (ASFA) and we decided to extend the number of TPE treatments to sixteen. Conclusions: Although the first case of Guillain-Barré syndrome was described a century ago, there are still many dark sides about its etiology, pathogenesis, clinical variants and therapeutic strategies. Further studies are necessary to find answer to many still unanswered questions. The management of these patients must include a high index of clinical suspicion, a prompt diagnosis and adequate therapy without mistakes.