{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T13:32:00Z","timestamp":1769607120777,"version":"3.49.0"},"reference-count":30,"publisher":"FapUNIFESP (SciELO)","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arq. Neuro-Psiquiatr."],"published-print":{"date-parts":[[2015,10]]},"abstract":"<jats:p>Objective In certain situations, severe forms of Guillain-Barr\u00e9 syndrome (GBS) show no response or continue to deteriorate after intravenous immunoglobulin (IVIg) infusion. It is unclear what the best treatment option would be in these circumstances.Method This is a case report on patients with severe axonal GBS in whom a second cycle of IVIg was used.Results Three patients on mechanical ventilation who presented axonal variants of GBS, with autonomic dysfunction, bulbar impairment and Erasmus score &gt; 6, showed no improvement after IVIg infusion of 400 mg\/kg\/d for 5 days. After 6 weeks, we started a second cycle of IVIg using the same doses and regimen as in the previous one. On average, 5 days after the second infusion, all the patients were weaned off mechanical ventilation and showed resolution of their blood pressure and heart rate fluctuations.Conclusions A second cycle of IVIg may be an option for treating severe forms of GBS.<\/jats:p>","DOI":"10.1590\/0004-282x20150136","type":"journal-article","created":{"date-parts":[[2015,10,8]],"date-time":"2015-10-08T01:19:29Z","timestamp":1444267169000},"page":"848-851","source":"Crossref","is-referenced-by-count":13,"title":["Is a second cycle of immunoglobulin justified in axonal forms of Guillain-Barr\u00e9 syndrome?"],"prefix":"10.1590","volume":"73","author":[{"given":"Daniel Agustin","family":"Godoy","sequence":"first","affiliation":[{"name":"Sanatorio Pasteur, Argentina; Hospital San Juan Bautista, Argentina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alejandro","family":"Rabinstein","sequence":"additional","affiliation":[{"name":"Mayo Clinic, United 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