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Seven adult patients received human immune globulin intravenously as initial therapy for Guillain-Barre syndrome.Although all patients initially stabilized or improved,five patients deteriorated one to 16 days after completion of treatment.In all five patients,clinical worsening included loss of at least one functional grade together with a decreased forced vital capacity.We subsequently treated each patient with a course of plasma exchange,which led to varying degrees of clinical improvement in four.In contrast to previously reported relapse rates for Guillain-Barre syndrome,our experience suggests that clinically significant relapses may occur in patients more often following human immune globulin therapy than after either plasma exchange or no therapy. |
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