O uso de corticosteróides na síndrome de Guillain-Barré: estudo de 51 casos

Dias-Tosta, Elza; Brasil, Joaquim Pereira; Figueiredo, Marco Antônio de Arruda

doi:10.1590/S0004-282X1986000200002

Resumos

Os autores fazem estudo retrospectivo de 51 pacientes com síndrome de Guillain-Barré, internados no Hospital de Base do Distrito Federal de 1974 a 1984. Dezoito desses doentes foram tratados com corticosteróides (prednisona ou dexametasona) e os outros 33 não receberam esse tipo de medicação. A evolução clínica (grau de recuperação, seqüelas, complicações, causa mortis) e o tempo de internação são comparados nesses dois grupos. Conclui-se que a corticoterapia não alterou de modo significativo a evolução da doença. Além disso, os dois únicos casos de recidivas ocorreram em pacientes tratados com corticosteróides.

This is a retrospective analysis of 51 patients admitted to the Hospital de Base do Distrito Federal (Brasilia, Brazil), with the Guillain-Barré syndrome, from 1974 to 1984. Eighteen patients were treated with corticosteroids (prednisone or dexamethasone), whereas 33 did not receive such treatment. The clinical course (degree of recovery, sequelae, complications, causa mortis) and the length of the hospital stay were compared in these two groups. It is concluded that the use of corticosteroids did not have a major effect on the clinical course of the illness. Moreover, the only two cases of relapses occurred in patients that had been treated with corticosteroids.

Elza Dias-Tosta^I; Joaquim Pereira Brasil^II; Marco Antônio de Arruda Figueiredo^II

^INeurologista - Trabalho realizado na Unidade de Neurologia do Hospital de Base do Distrito Federal (HBDF)

^IIMédico Residente - Trabalho realizado na Unidade de Neurologia do Hospital de Base do Distrito Federal (HBDF)

RESUMO

Os autores fazem estudo retrospectivo de 51 pacientes com síndrome de Guillain-Barré, internados no Hospital de Base do Distrito Federal de 1974 a 1984. Dezoito desses doentes foram tratados com corticosteróides (prednisona ou dexametasona) e os outros 33 não receberam esse tipo de medicação. A evolução clínica (grau de recuperação, seqüelas, complicações, causa mortis) e o tempo de internação são comparados nesses dois grupos. Conclui-se que a corticoterapia não alterou de modo significativo a evolução da doença. Além disso, os dois únicos casos de recidivas ocorreram em pacientes tratados com corticosteróides.

SUMMARY

This is a retrospective analysis of 51 patients admitted to the Hospital de Base do Distrito Federal (Brasilia, Brazil), with the Guillain-Barré syndrome, from 1974 to 1984. Eighteen patients were treated with corticosteroids (prednisone or dexamethasone), whereas 33 did not receive such treatment. The clinical course (degree of recovery, sequelae, complications, causa mortis) and the length of the hospital stay were compared in these two groups. It is concluded that the use of corticosteroids did not have a major effect on the clinical course of the illness. Moreover, the only two cases of relapses occurred in patients that had been treated with corticosteroids.

Texto completo disponível apenas em PDF.

Full text available only in PDF format.

Hospital de Base do Distrito Federal . Unidade de Neurologia - SHLS - 70S35 -Brasília, DF - Brasil.

1. AARLI, J.A. - Plasma exchange in the Guillain-Barre syndrome: is there a rationale? In Neuroimmunology. Raven Press, New York, 1984, pg. 371.
2. ANDERSSON, T. & SIDÉN, A. - A clinical study of the Guillain-Barre syndrome. Acta neurol. scand. 66 : 316, 1982
3. ARNASON, B.G.W. - Acute inflammatory demyelinating polyradiculoneuropathies. In P.J. Dyck, P.K. Thomas, B.H. Lambert & R. Bunge (eds.): Peripheral Neuropathy, Vol. II, Saunders, Philadelphia, 1984, pg. 2050.
4. ASBURY, A.K. - Diagnostic considerations in Guillain-Barrg syndrome. Ann. Neurol. 9 (suppl): 1, 1981.
5. BEZWODA, W.R.; FRITZ, V.; REEF, H.E.; STAUB, H.; DERMAN, D.P.; LEWIS, M.; KALLENBACH, J.; ZALTZMAN, M. & NAUGHTON, M.A. - Treatment of acute post-infective polyneuropathy by means of plasma exchange. Acta neurol. scand. 69: 112, 1984.
6. DAV1ES, A.G. & DINGLE, H.R. - Observations on cardiovascular and neuroendocrine disturbance in the Guillain-Barré syndrome. J. Neurol. Neurosurg. Psychiat. 35: 176, 1972.
7. HUGHES, R.A.C.; KADLUBOWSKI, M. & HUFSCHMIDT, A. - Treatment of acute inflammatory polyneuropathy. Ann. Neurol. 9 (suppl): 125, 1981.
8. HUGHES, R.A.C.; NEWSOM-DAVIS, J.M.; PERKIN, G.D. & PIERCE, J.M. - Controlled trial of prednisolone in acute polyneuropathy. Lancet 2 : 750, 1978.
9. OSTERMAN, P.E.; FAGIUS, J.; SAFWENBERG, J.; DANERSUND, A.; GUNNAR WALLIN, B. & NORDESJO, L.O. - Treatment of the Guillain-Barre syndrome by plasmapheresis. Arch. Neurol. 39: 148, 1982.
10. PLUM, F. - Multiple symmetrical polyneuropathy treated with cortisone. Neurology 3 : 661, 1953.
11. POSNER, J.B.; ERTEL, N.H.; KOSSMANN, R.J. & SCHEINBERG, L.C. - Hyponatremia in acute polyneuropathy. Arch. Neurol. 17: 530, 1967.
12. POTES, J.; ORDÓÑEZ, N. & PALACIOS, E. - Polirradiculoneuritis idiopática aguda: alteraciones neurovegetatives (síndrome de Guillain-Barré). Tribuna Médica (41) 491: A4, 1971.
13. ROSEN, A.D. & VASTOLA, E.F. - Clinical effects of cyclophosphamide in Guillain-Barré polyneuritis. J. neurol. Sci. 30: 179, 1976.
14. SAMANTRAY, S.K.; JOHNSON, S.C.; MATHAI, K.V. & PULIMOOD, B.M. - Landry-Guillain-Barré-Strohl syndrome: a study of 302 cases. Med. J. Aust. 2: 84, 1977.
15. SANDU, L. - Corticosteroids in Landry-Guillain-Barré-Strohl syndrome. Lancet 2: 662, 1974.
16. SHY, G.M. & Mc EACHERN, D. - Further studies on the effect of cortisone and ACTH in neurological disorders. Brain 74 : 354, 1951.
17. The Guillain-Barré Syndrome Study Group: plasmapheresis and acute Guillain-Barré syndrome. Neurology 35: 1096, 1985.

O uso de corticosteróides na síndrome de Guillain-Barré: estudo de 51 casos

The use of corticosteroids in the Guillain-Barré syndrome: report of 51 cases

Datas de Publicação

Publicação nesta coleção
29 Jun 2011
Data do Fascículo
Jun 1986

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. AARLI, J.A. - Plasma exchange in the Guillain-Barre syndrome: is there a rationale? In Neuroimmunology. Raven Press, New York, 1984, pg. 371.

[2] 2. ANDERSSON, T. & SIDÉN, A. - A clinical study of the Guillain-Barre syndrome. Acta neurol. scand. 66 : 316, 1982

[3] 3. ARNASON, B.G.W. - Acute inflammatory demyelinating polyradiculoneuropathies. In P.J. Dyck, P.K. Thomas, B.H. Lambert & R. Bunge (eds.): Peripheral Neuropathy, Vol. II, Saunders, Philadelphia, 1984, pg. 2050.

[4] 4. ASBURY, A.K. - Diagnostic considerations in Guillain-Barrg syndrome. Ann. Neurol. 9 (suppl): 1, 1981.

[5] 5. BEZWODA, W.R.; FRITZ, V.; REEF, H.E.; STAUB, H.; DERMAN, D.P.; LEWIS, M.; KALLENBACH, J.; ZALTZMAN, M. & NAUGHTON, M.A. - Treatment of acute post-infective polyneuropathy by means of plasma exchange. Acta neurol. scand. 69: 112, 1984.

[6] 6. DAV1ES, A.G. & DINGLE, H.R. - Observations on cardiovascular and neuroendocrine disturbance in the Guillain-Barré syndrome. J. Neurol. Neurosurg. Psychiat. 35: 176, 1972.

[7] 7. HUGHES, R.A.C.; KADLUBOWSKI, M. & HUFSCHMIDT, A. - Treatment of acute inflammatory polyneuropathy. Ann. Neurol. 9 (suppl): 125, 1981.

[8] 8. HUGHES, R.A.C.; NEWSOM-DAVIS, J.M.; PERKIN, G.D. & PIERCE, J.M. - Controlled trial of prednisolone in acute polyneuropathy. Lancet 2 : 750, 1978.

[9] 9. OSTERMAN, P.E.; FAGIUS, J.; SAFWENBERG, J.; DANERSUND, A.; GUNNAR WALLIN, B. & NORDESJO, L.O. - Treatment of the Guillain-Barre syndrome by plasmapheresis. Arch. Neurol. 39: 148, 1982.

[10] 10. PLUM, F. - Multiple symmetrical polyneuropathy treated with cortisone. Neurology 3 : 661, 1953.

[11] 11. POSNER, J.B.; ERTEL, N.H.; KOSSMANN, R.J. & SCHEINBERG, L.C. - Hyponatremia in acute polyneuropathy. Arch. Neurol. 17: 530, 1967.

[12] 12. POTES, J.; ORDÓÑEZ, N. & PALACIOS, E. - Polirradiculoneuritis idiopática aguda: alteraciones neurovegetatives (síndrome de Guillain-Barré). Tribuna Médica (41) 491: A4, 1971.

[13] 13. ROSEN, A.D. & VASTOLA, E.F. - Clinical effects of cyclophosphamide in Guillain-Barré polyneuritis. J. neurol. Sci. 30: 179, 1976.

[14] 14. SAMANTRAY, S.K.; JOHNSON, S.C.; MATHAI, K.V. & PULIMOOD, B.M. - Landry-Guillain-Barré-Strohl syndrome: a study of 302 cases. Med. J. Aust. 2: 84, 1977.

[15] 15. SANDU, L. - Corticosteroids in Landry-Guillain-Barré-Strohl syndrome. Lancet 2: 662, 1974.

[16] 16. SHY, G.M. & Mc EACHERN, D. - Further studies on the effect of cortisone and ACTH in neurological disorders. Brain 74 : 354, 1951.

[17] 17. The Guillain-Barré Syndrome Study Group: plasmapheresis and acute Guillain-Barré syndrome. Neurology 35: 1096, 1985.