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Case Report | Hematology | Volume 15 Issue 8, August 2026 | Pages: 1195 - 1197 | India
Therapeutic Plasma Exchange in Guillain-Barre Syndrome: A Case Report
Abstract: Guillain-Barre syndrome (GBS) is an acute immune-mediated polyradiculoneuropathy characterized by rapidly progressive symmetrical weakness, areflexia, and variable sensory or autonomic involvement. Therapeutic plasma exchange (TPE) is a Category I indication for GBS as per the American Society for Apheresis (ASFA) guidelines and is recommended by the Directorate General of Health Services (DGHS) for the clinical application of therapeutic apheresis. We report a 54-year-old female with the acute motor-sensory axonal neuropathy (AMSAN) variant of GBS, who had already received intravenous immunoglobulin (IVIg) at another hospital five days prior to presentation, and who subsequently underwent five alternate-day sessions of one-plasma-volume TPE using the Spectra Optia® apheresis system via right femoral venous access. 5% albumin and normal saline were used as replacement fluids, with ACD-A anticoagulation and calcium gluconate supplementation. Plasma exchange volumes ranged from 2432-3114 mL per session. A transient hypotensive episode occurred during the first session, after which all subsequent procedures were hemodynamically stable. Upper-limb power remained stable at 4/5 bilaterally throughout, while lower-limb power improved progressively from 1/5 (Cycles 1-2) to 2/5 (Cycles 3-4) and 3/5 after Cycle 5. Deep tendon reflexes remained absent throughout the TPE sessions, with no sensory loss noted at any stage. The GBS disability score improved from 5 to 4 after the first cycle and remained stable at 4 through the remaining sessions. At the Day 14 follow-up, lower-limb power remained 3/5, deep tendon reflexes had returned, sensory examination was normal, and the GBS disability score had further improved to 3, indicating functional recovery with assisted ambulation. Five sessions of TPE were completed safely and were associated with progressive improvement in lower-limb motor power and functional status. Apart from a transient hypotensive episode and manageable electrolyte abnormalities, no major procedure-related complications occurred, supporting the safety and effectiveness of TPE in this patient with GBS.
Keywords: Guillain-Barre syndrome, therapeutic plasma exchange, apheresis, AMSAN, GBS disability score
How to Cite?: Dr. Karthik Balaji S, Dr. Rajshree Behra, Dr. Nathiya, Dr. Riya, Dr. Neeraj, "Therapeutic Plasma Exchange in Guillain-Barre Syndrome: A Case Report", Volume 15 Issue 8, August 2026, International Journal of Science and Research (IJSR), Pages: 1195-1197, https://www.ijsr.net/getabstract.php?paperid=MR26813113842, DOI: https://dx.doi.org/10.21275/MR26813113842