A female in her 70s experienced weakness in her legs, trouble swallowing, and several falls. When she fell and couldn’t get up, she called an ambulance and was transported to a local hospital.
Physicians at the hospital consulted Duke Health’s neurology experts, who suggested a diagnosis of Guillain-Barre syndrome. The local hospital initiated a standard treatment for Guillain Barre—intravenous immunoglobulin (IVIG)—but the patient did not respond after two treatments. Because of a rapid deterioration of muscular function, she was transferred to Duke Hospital overnight. The deterioration ascended from her feet and began to compromise her pharyngeal and respiratory muscles.
“When I arrived at the hospital, she was decompensating quickly. She was taken to the neurological ICU where she was intubated and placed on a ventilator,” says Jordan L. Mayberry, MD, a neuromuscular specialist on duty that day. Mayberry was concerned by her lack of response to IVIG. To head off any further deterioration, he made the fast decision to change to a treatment the local hospital did not offer.
What therapy — offered at Duke but few other North Carolina hospitals — did Mayberry institute for a better chance at speeding the patient’s recovery?