1.Prevalence of Anti-Ganglioside Antibodies and Their Clinical Correlates with Guillain-Barre Syndrome in Korea: A Nationwide Multicenter Study.
Jong Kuk KIM ; 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
Journal of Clinical Neurology 2014;10(2):94-100
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.
Amantadine
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Antibodies*
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Axons
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Cranial Nerves
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Facial Nerve
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Guillain-Barre Syndrome*
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Humans
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Immunoglobulin G
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Immunoglobulin M
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Korea
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Male
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Ophthalmoplegia
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Prevalence*
Result Analysis
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