Comparison of Intravenous Immunoglobulin (IVIG) and Plasma Exchange in Children with Guillain-Barré Syndrome at a Tertiary Care Hospital in Lahore

Objective: To compare the outcome of IVIG and plasma exchange in treatment of Guillain-Barré Syndrome (GBS) in children. Study Design: Retrospective Longitudinal Study Place and Duration of Study:  Pediatric Intensive Care Unit (PICU), University of Child Health Sciences and The Children's Hospital, Lahore, Pakistan, from Oct 22 to Sep 23. Methodology: The study included all pediatric patients aged 1 to 14 years diagnosed with GBS admitted to the ICU. Retrospective data collection was done for the IVIG group, while prospective data collection was done for the plasmapheresis group. Demographics, hospitalization duration, mechanical ventilation period, treatment outcomes, and muscle power improvement were compared between the IVIG and plasmapheresis groups using the Medical Research Council (MRC) Score. Results: Among 150 patients, 62.7% were male, with mean age 6.19 ± 3.81 years and mean weight 19.75 ± 10.62 kg. The most common EMG/NCS finding was AMAN. Average PICU stay was 33.32 ± 13.79 days, and ventilation duration was 29.22 ± 14.33 days. Both IVIG and plasma groups showed significant muscle power improvement (p < 0.05). IVIG patients had shorter PICU stays (27.39 ± 10.50 days) and ventilation durations (23.13 ± 11.56 days) than plasma patients (39.25 ± 14.20 days and 35.31 ± 14.31 days, respectively, p < 0.05). Conclusion: Both IVIG and plasmapheresis are equally effective, but IVIG outperformed plasmapheresis regarding reduced duration of hospitalization and ventilation as well as need for tracheostomy.