IVIG Treatment May Lead to Poorer Outcomes in GBS Patients

A new study shows that individuals treated with intravenous immune globulin (IVIG) for Guillain-Barré syndrome (GBS) are at increased risk of developing hypoalbuminemia (reduced albumin levels), which may result in a more severe disease course and worse outcome. In the study, serum samples from 174 patients with GBS were analyzed before and after IVIG treatment at four time points to determine albumin levels and related muscle weakness, respiratory failure and walking ability. Before IVIG treatment, the median serum albumin level was 4.2 g/dL in 20 out of 156 patients with hypoalbuminemia. After two weeks of 2g/kg of IVIG treatment, the median serum albumin level fell to 3.7 g/dL, with 60 out of 174 patients experiencing hypoalbuminemia. Hypoalbuminemia was associated with increased levels of respiratory failure in 16 of 44 patients before and 29 of 53 patients after IVIG treatment. And, hypoalbuminemia was associated with decreased ability to walk unaided in 21 out of 60 patients after treatment versus six out of 114 patients before treatment, and increased severe muscle weakness at four weeks and six months after treatment. The researchers concluded that more research is needed to confirm whether serum albumin can be used as a biomarker to monitor disease activity and treatment response to IVIG in patients with GBS.