Albumin levels as a biomarker for second Intravenous Immunoglobulin (IVIG) treatment in Guillain-Barre syndrome (GBS).


Journal

Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia
ISSN: 1532-2653
Titre abrégé: J Clin Neurosci
Pays: Scotland
ID NLM: 9433352

Informations de publication

Date de publication:
Apr 2020
Historique:
received: 02 11 2019
accepted: 12 01 2020
pubmed: 24 2 2020
medline: 18 8 2020
entrez: 24 2 2020
Statut: ppublish

Résumé

Patients with GBS may develop hypoalbuminemia following treatment with Intravenous Immunoglobulin (IVIG), which is related to a poorer outcome. This report presents a patient with GBS and his clinical response to two courses of IVIG treatments in association with his albumin level. A previously healthy 21-year-old male was admitted to the GICU due to GBS with severity grade 5 (required assisted ventilation). IVIG treatment was initiated. Over the next two weeks there was no clinical improvement and Albumin level dropped from 4.5 gr/dL to a nadir of 2.3 gr/dL. A second course of IVIG was initiated. After initiation of the second course the patient's albumin began rising to 3.0 gr/dL and a clinical improvement followed this rise. Subsequently, he was weaned from mechanical ventilation within a few days. When considering a second course of IVIG treatment, serum albumin levels may be considered a biomarker as part of the decision algorithm.

Sections du résumé

BACKGROUND BACKGROUND
Patients with GBS may develop hypoalbuminemia following treatment with Intravenous Immunoglobulin (IVIG), which is related to a poorer outcome. This report presents a patient with GBS and his clinical response to two courses of IVIG treatments in association with his albumin level.
CASE REPORT METHODS
A previously healthy 21-year-old male was admitted to the GICU due to GBS with severity grade 5 (required assisted ventilation). IVIG treatment was initiated. Over the next two weeks there was no clinical improvement and Albumin level dropped from 4.5 gr/dL to a nadir of 2.3 gr/dL. A second course of IVIG was initiated. After initiation of the second course the patient's albumin began rising to 3.0 gr/dL and a clinical improvement followed this rise. Subsequently, he was weaned from mechanical ventilation within a few days.
CONCLUSIONS CONCLUSIONS
When considering a second course of IVIG treatment, serum albumin levels may be considered a biomarker as part of the decision algorithm.

Identifiants

pubmed: 32088107
pii: S0967-5868(19)32165-4
doi: 10.1016/j.jocn.2020.01.067
pii:
doi:

Substances chimiques

Albumins 0
Biomarkers 0
Immunoglobulins, Intravenous 0

Types de publication

Case Reports

Langues

eng

Sous-ensembles de citation

IM

Pagination

247-249

Commentaires et corrections

Type : CommentIn
Type : CommentIn

Informations de copyright

Copyright © 2020 Elsevier Ltd. All rights reserved.

Auteurs

Anna Shalman (A)

Department of Anesthesiology and Critical Care, General Intensive Care Unit, Soroka Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel.

Shiri Savir (S)

Department of Anesthesiology and Critical Care, General Intensive Care Unit, Soroka Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel. Electronic address: yona.shiri@gmail.com.

Yana Mechnik Steen (Y)

Department of Neurology Soroka Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel. Electronic address: yaname@clalit.org.il.

Andrey Ovanyan (A)

Department of Neurology Soroka Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel. Electronic address: andreyov@clalit.org.il.

Nancy Boniel (N)

Department of Radiology, Soroka Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel.

Leonid Koyfman (L)

Department of Anesthesiology and Critical Care, General Intensive Care Unit, Soroka Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel.

Yoav Bichovsky (Y)

Department of Anesthesiology and Critical Care, General Intensive Care Unit, Soroka Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel.

Alexander Zlotnik (A)

Department of Anesthesiology and Critical Care, General Intensive Care Unit, Soroka Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel.

Moti Klein (M)

Department of Anesthesiology and Critical Care, General Intensive Care Unit, Soroka Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel. Electronic address: motik@clalit.org.il.

Evgeni Brotfain (E)

Department of Anesthesiology and Critical Care, General Intensive Care Unit, Soroka Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel.

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