Intravenous immunoglobulin in the Guillain-Barre syndrome

EDITOR,-R A C Hughes's editorial on the use of intravenous immunoglobulin in the Guillain-Barre syndrome concludes that this treatment is beneficial and is easier than plasma exchange to administer. 1 We agree with this but wish to draw attention to potentially severe adverse skin reactions to the treatment. A patient has been successfully treated with intravenous immunoglobulin and steroid cover after developing eczema, 3 and the combination of intravenous immunoglobulin and steroid has been evaluated recently. 4 This may well be optimal treatment, if only because the side effects of the immunoglobulin are lessened, but our experience is that the skin condition may recur despite such treatment.