Can growth hormone lead to a faster recovery from Guillain-Barree syndrome? Case report of the first therapeutic use in one patient

Although the prognosis in Guillain-Barre syndrome (GBS) is generally good, protracted and incomplete courses of recovery can be a heavy burden. Animal studies suggest growth hormone (GH) treatment could stimulate myelin repair and thus accelerate functional recovery in acute polyneuropathy. We report on the first use of GH in GBS. Our objective was to monitor safety and tolerability as well as to evaluate the effect of an off-label GH therapy during recovery from GBS in one patient. A 28-year-old male with flaccid tetraparesis caused by pure motor GBS was treated off-label with GH (1 mg/day) for 10 weeks. Muscle strength was measured regularly before, during and after the treatment over a total span of 330d. Serum levels of IGF-I were assessed before, during and after GH treatment. Changes in strength gain were used as the main parameter of efficacy. No side effects of GH treatment were observed. Serum IGF-I increased from 177 ng/mL at baseline to an average of 342 ng/mL (normal range 78 - 270 ng/mL) during treatment. Prior to GH administration, strength (R-2=0.99, p<0.01) was associated with time, representing the natural course of recovery. During GH treatment, the slope of strength gain increased (Glass' increment =1.08, p<0.01). The association between alterations of strength gain and IGF-I serum levels reached trend-level (R-2=0.36, p=0.09). In this single case, GH treatment seemed to be associated with faster muscular strength gain. Controlled studies are needed in order to establish GH as a potential therapeutic approach in motor GBS.