Ataxic Guillain-Barré syndrome associated with anti-GM1b and anti-GalNAc-GD1a antibodies
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- 作者：Masaaki Odaka ; Nobuhiro Yuki ; Muneto Tatsumoto ; Masaru Tateno and Koichi Hirata
- 关键词：Key words ataxic Guillain ; Barré ; syndrome ; Fisher syndrome ; anti ; GM1b antibody ; anti ; GalNAc ; GD1a antibody
- 刊名：Journal of Neurology
- 出版年：2004
- 出版时间：January 2004
- 年：2004
- 卷：251
- 期：1
- 页码：24-29
- 全文大小：873 KB
- 刊物类别：Medicine
- 刊物主题：Medicine & Public Health
Neurology
Neurosciences
Neuroradiology - 出版者：Springer Berlin / Heidelberg
- ISSN：1432-1459
文摘
Ataxic Guillain-Barré syndrome (GBS) associated withanti-GQ1b IgG antibody has been reported. We, however, have hada patient with ataxic GBS who had IgG antibodies to the minorgangliosides GM1b and GalNAc-GD1a, and we thereforeretrospectively investigated the clinical features of patientswho had antibodies to GM1b or GalNAc-GD1a, but not to GQ1b.Information on patients antecedent illnesses, initial symptoms,neurological signs, and CSF findings was reviewed in those withataxic GBS or Fisher syndrome (FS) with anti-GM1b oranti-GalNAc-GD1a IgG antibodies. We tested whether the anti-GM1band anti-GalNAc-GD1a antibodies are cross-reactive andconstructed three-dimensional structural models of GM1b andGalNAc-GD1a. Ataxic GBS was diagnosed in 1 of 65 patients whohad both anti-GM1b and anti-GalNAc-GD1a antibodies and in 3 of159 patients who had anti-GM1b antibody without anti-GalNAc-GD1aantibody: FS was diagnosed in 1 of the 159 patients and in 1 of35 who had anti-GalNAc-GD1a antibody without anti-GM1b antibody.All the patients antibodies to GM1b or GalNAc-GD1a wereassociated with the IgG isotype. The clinical features ofpatients with ataxic GBS associated with anti-GM1b oranti-GalNAc-GD1a IgG antibodies did not differ from those ofpatients who had anti-GQ1b IgG antibody. Absorption studyfindings for serum from the patient who had both anti-GM1b andanti-GalNAc-GD1a IgG antibodies showed significant absorbance ofanti-GM1b IgG antibody by GalNAc-GD1a and of anti-GalNAc-GD1aIgG antibody by GM1b, indicating that these antibodies arecross-reactive. This is the first report of ataxic GBS or FSassociated with anti-GM1b or anti-GalNAc-GD1a IgG antibodies.These autoantibodies, as well as anti-GQ1b IgG antibody, mayfunction in the development of some patients with ataxic GBS andFS.