Immunosuppression and the Guillain-Barre Syndrome

Publisher Website
Google Scholar
Abstract
ALTHOUGH idiopathic polyneuritis, or the "Landry-Guillain-Barré (LGB) syndrome" has been known for more than 100 years,1its nosologic limits, etiology, and treatment remain a matter of controversy.2-23Current opinion favors an autoallergic pathogenesis, and many authors have drawn attention to experimental allergic neuritis (EAN) first described by Waksman and Adams24as the appropriate experimental model of this clinical condition.12,14-17As a natural outgrowth of this concept, immunosuppressive treatment has been suggested as specific therapy for the LGB syndrome. Experimentally, steroids have been shown to prevent EAN,25and both steroids and immunosuppressive drugs will prevent the closely related experimental allergic encephalomyelitis (EAE) consistently in animals.26-30With but one exception,31the drugs are effective only if given before the onset of clinical evidence of paralysis. The use of steroids and adrenocorticotropic hormone in humans with idiopathic polyneuritis has been less successful, however.5,7,10,12,-17,21-23,32