Efficacy of mini-pool intravenous immunoglobulin prepared by Assiut University Hospital blood bank in Guillain–Barré syndrome

Abstract

Background
Guillain–Barré syndrome (GBS) is an immune-mediated acute polyradiculoneuropathy that typically occurs after infectious diseases. The present study aimed to evaluate the efficacy, safety, and pharmacokinetics of mini-pool intravenous immunoglobulin (MP-IVIG) prepared by Central Blood Transfusion Services (CBTS) in pediatric patients with GBS.


Patients and methods
The study was done in the plasma fractionation unit of CBTS at the Clinical Pathology Department, and Neurology Unit in Assiut University Pediatric Hospital during the period between April 2022 and February 2024. The study included two groups: group I: 25 patients diagnosed as GBS received MP-IVIG prepared by CBTS.
Group II: 25 patients diagnosed as GBS received standard IVIG.


Results

There were no significant differences between the MP-IVIG and standard IVIG groups regarding demographic characteristics such as sex, age, and weight. Both groups showed a comparable and favorable response to treatment, with 84 and 88% of patients responding positively, respectively (
P
=1.000), and most patients experienced no side effects. All MP-IVIG patients had negative serological and direct Coombs’ tests before and after treatment. Significant improvement in muscle strength was observed in both groups based on the Medical Research Council scale score (
P
<0.001), with most patients improving from grade 2 to grade 4. White blood cell counts significantly decreased posttreatment in both groups, and in the MP-IVIG group, immunoglobulin G levels increased significantly at 2 weeks (
P
<0.001), then gradually returned to baseline by 6 months.



Conclusion
Our study demonstrates that MP-IVIG is a safe, well tolerated, and effective treatment for pediatric GBS, with efficacy comparable to standard IVIG and no new adverse events reported.