Prevalence of Anti-Ganglioside Antibodies and Their Clinical Correlates with Guillain-Barre Syndrome in Korea: A Nationwide Multicenter Study.
- Author:
Jong Kuk KIM
1
;
Jong Seok BAE
;
Dae Seong KIM
;
Susumu KUSUNOKI
;
Jong Eun KIM
;
Ji Soo KIM
;
Young Eun PARK
;
Ki Jong PARK
;
Hyun Seok SONG
;
Sun Young KIM
;
Jeong Geun LIM
;
Nam Hee KIM
;
Bum Chun SUH
;
Tai Seung NAM
;
Min Su PARK
;
Young Chul CHOI
;
Eun Hee SOHN
;
Sang Jun NA
;
So Young HUH
;
Ohyun KWON
;
Su Yun LEE
;
Sung Hoon LEE
;
Sun Young OH
;
Seong Hae JEONG
;
Tae Kyeong LEE
;
Dong Uk KIM
Author Information
- Publication Type:Multicenter Study ; Original Article
- Keywords: Guillain-Barre syndrome; ganglioside; antibodies; Korea; acute motor axonal neuropathy
- MeSH: Amantadine; Antibodies*; Axons; Cranial Nerves; Facial Nerve; Guillain-Barre Syndrome*; Humans; Immunoglobulin G; Immunoglobulin M; Korea; Male; Ophthalmoplegia; Prevalence*
- From:Journal of Clinical Neurology 2014;10(2):94-100
- CountryRepublic of Korea
- Language:English
- Abstract: BACKGROUND AND PURPOSE: No previous studies have investigated the relationship between various anti-ganglioside antibodies and the clinical characteristics of Guillain-Barre syndrome (GBS) in Korea. The aim of this study was to determine the prevalence and types of anti-ganglioside antibodies in Korean GBS patients, and to identify their clinical significance. METHODS: Serum was collected from patients during the acute phase of GBS at 20 university-based hospitals in Korea. The clinical and laboratory findings were reviewed and compared with the detected types of anti-ganglioside antibody. RESULTS: Among 119 patients, 60 were positive for immunoglobulin G (IgG) or immunoglobulin M antibodies against any type of ganglioside (50%). The most frequent type was IgG anti-GM1 antibody (47%), followed by IgG anti-GT1a (38%), IgG anti-GD1a (25%), and IgG anti-GQ1b (8%) antibodies. Anti-GM1-antibody positivity was strongly correlated with the presence of preceding gastrointestinal infection, absence of sensory symptoms or signs, and absence of cranial nerve involvement. Patients with anti-GD1a antibody were younger, predominantly male, and had more facial nerve involvement than the antibody-negative group. Anti-GT1a-antibody positivity was more frequently associated with bulbar weakness and was highly associated with ophthalmoplegia when coupled with the coexisting anti-GQ1b antibody. Despite the presence of clinical features of acute motor axonal neuropathy (AMAN), 68% of anti-GM1- or anti-GD1a-antibody-positive cases of GBS were diagnosed with acute inflammatory demyelinating polyradiculoneuropathy (AIDP) by a single electrophysiological study. CONCLUSIONS: Anti-ganglioside antibodies were frequently found in the serum of Korean GBS patients, and each antibody was correlated strongly with the various clinical manifestations. Nevertheless, without an anti-ganglioside antibody assay, in Korea AMAN is frequently misdiagnosed as AIDP by single electrophysiological studies.
