uzspbgmuУчёные записки Первого Санкт-Петербургского государственного медицинского университета имени академика И. П. ПавловаThe Scientific Notes of the Pavlov University1607-41812541-8807Academician I.P. Pavlov First St. Petersburg State Medical University10.24884/1607-4181-2018-25-3-96-103uzspbgmu-524Research ArticleВ ПОМОЩЬ ПРАКТИЧЕСКОМУ ВРАЧУPRACTICAL GUIDELINESОПЫТ ПРИМЕНЕНИЯ ПЛАЗМАФЕРЕЗА ПРИ ОСТРОЙ ВОСПАЛИТЕЛЬНОЙ ДЕМИЕЛИНИЗИРУЮЩЕЙ ПОЛИРАДИКУЛОНЕВРОПАТИИ ГИЙЕНА – БАРРЕ У ПАЦИЕНТКИ С ХРОНИЧЕСКИМ ВИРУСНЫМ ГЕПАТИТОМ С И САХАРНЫМ ДИАБЕТОМ 2-го ТИПАEXPERIENCE IN THE USE OF PLASMAPHERESIS IN ACUTE INFLAMMATORY DEMYELINATING POLYRADICULONEUROPATHY GUILLAIN – BARRE SYNDROME IN THE PATIENT WITH CHRONIC HEPATITIS C VIRUS INFECTION AND TYPE 2 DIABETES MELLITUSВоиновВ. А.VoinovV. A.

197022, Санкт-Петербург, ул. Льва Толстого, д. 6-8.

 

6-8 L’va Tolstogo street, Saint-Petersburg, 197022.

voinof@mail.ruhttps://orcid.org/0000-0002-4440-8353ГапешинР. А.GapeshinR. A.

197022, Санкт-Петербург, ул. Льва Толстого, д. 6-8.

6-8 L’va Tolstogo street, Saint-Petersburg, 197022.

gapeshin.ra@gmail.comТарабановаЕ. С.TarabanovaE. S.

197022, Санкт-Петербург, ул. Льва Толстого, д. 6-8.

6-8 L’va Tolstogo street, Saint-Petersburg, 197022.

elena_beznos@mail.ruЯковлевА. А.IakovlevA. A.

197022, Санкт-Петербург, ул. Льва Толстого, д. 6-8.

6-8 L’va Tolstogo street, Saint-Petersburg, 197022.

yakovlev-aa@mail.ruКарчевскийК. С.KarchevskiiK. S.

197022, Санкт-Петербург, ул. Льва Толстого, д. 6-8.

6-8 L’va Tolstogo street, Saint-Petersburg, 197022.

voinof@mail.ruИсауловО. В.IsaulovO. V.

197022, Санкт-Петербург, ул. Льва Толстого, д. 6-8.

6-8 L’va Tolstogo street, Saint-Petersburg, 197022.

voinof@mail.ruФедеральное государственное бюджетное образовательное учреждение высшего образования «Первый Санкт-Петербургский государственный медицинский университет имени академика И. П. Павлова» Министерства здравоохранения Российской Федерации.РоссияPavlov University.Russian FederationФедеральное государственное бюджетное образовательное учреждение высшего образования «Первый Санкт-Петербургский государственный медицинский университет имени академика И. П. Павлова» Министерства здравоохранения Российской Федерации; Федеральное государственное бюджетное образовательное учреждение высшего образования «Северо-Западный государственный медицинский университет имени И. И. Мечникова» Министерства здравоохранения Российской Федерации.РоссияPavlov University; Federal State Budgetary Educational Institution of Higher Education «North-Western State Medical University named after I. I. Mechnikov» of the Ministry of Healthcare of the Russian Federation.Russian Federation20183009201825396103Copyright © Воинов В.А., Гапешин Р.А., Тарабанова Е.С., Яковлев А.А., Карчевский К.С., Исаулов О.В., 20182018Воинов В.А., Гапешин Р.А., Тарабанова Е.С., Яковлев А.А., Карчевский К.С., Исаулов О.В.Voinov V.A., Gapeshin R.A., Tarabanova E.S., Iakovlev A.A., Karchevskii K.S., Isaulov O.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.sci-notes.ru/jour/article/view/524

Острая воспалительная демиелинизирующая полирадикулоневропатия Гийена – Барре (ОВДП-ГБ) – приобретенное иммуноопосредованное заболевание с острым началом, характеризующееся развитием периферического тетрапареза вследствие поражения нервных стволов и корешков клетками собственной иммунной системы. Представлено описание клинического случая развития ОВДП-ГБ у пациентки, страдающей гепатитом С и сахарным диабетом 2-го типа. Пациентке был проведен курс плазмафереза и для увеличения эффективности терапии – последующий курс инфузий внутривенного иммуноглобулина (ВВИГ). На фоне данной терапии было отмечено существенное улучшение состояния пациентки и снижение неврологического дефицита, подтвержденное данными неврологического осмотра и электронейромиографии, сразу после проведения лечения и через 6 месяцев. Также пациентке выполнялись реабилитационные мероприятия, включавшие занятия лечебной физкультурой, сеансы физиотерапии и рефлексотерапии. Таким образом, эффективное лечение ОВДП-ГБ складывается из патогенетической терапии (плазмаферез, ВВИГ) и реабилитационных мероприятий, позволяющих ускорить выздоровление пациента и возвращение его к трудовой деятельности.

Acute inflammatory demyelinating polyneuropathy Guillain – Barre syndrome (AIDP-GB) – acquired immune mediated disease with acute onset characterized by the development of peripheral tetraparesis due to immune system attack to peripheral nerves and spinal roots. This article describes the case report of AIDP-GB development in the patient with hepatitis C and type 2 diabetes mellitus. The patient was treated with course of plasmapheresis and subsequent course of intravenous immunoglobulin (IVIG) for increasing the effectiveness of therapy. During the therapy, there was a significant improvement in the condition of patient and reduction of neurological deficit, confirmed by neurological examination and electroneuromyography, immediately after treatment and in 6 months. In addition, rehabilitation measures for the patient included physical therapy, including physiotherapy and acupuncture. To sum up, the effective treatment of AIDP-GB includes pathogenic therapy (plasmapheresis, IVIG) and rehabilitation measures to facilitate the recovery of the patient and return to professional practice.

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The authors declare that there are no conflicts of interest present.