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Neurology. 2014 Jan 14;82(2):114-8. doi: 10.1212/WNL.0000000000000015. Epub 2013 Dec 6.

Anti-neutral glycolipid antibodies in encephalomyeloradiculoneuropathy.

Author information

  • 1From the Department of Neurology (S.S., N.K., T.I., Y.N., A.U., T.M.), Fujita Health University School of Medicine, Aichi; and Institute for Environmental and Gender Specific Medicine (H.M., C.I., K.I.), Juntendo University Graduate School of Medicine, Chiba, Japan.

Abstract

OBJECTIVE:

The aim of this study was to review 4 patients with encephalomyeloradiculoneuropathy (EMRN) and assess for autoantibodies against neutral glycolipids.

METHODS:

We studied the progression of clinical, radiologic, neurophysiologic, and CSF findings, as well as anti-neutral glycolipid antibodies in sera.

RESULTS:

All patients developed acute or subacute motor weakness and impaired consciousness. Their CSF showed pleocytosis and high immunoglobulin G concentrations. MRI revealed lesions in the brain and spinal cord. Neurophysiologic examinations indicated dysfunction of the spinal cord, nerve roots, and peripheral nerves. Steroid pulsed immunotherapy and/or high dose of IV immunoglobulin replacement therapy resulted in clear and often dramatic clinical improvements. Reactivity to anti-neutral glycolipid antibodies was positive in all patients with acute EMRN but not in the recovery phase. Forty-seven age-matched patients with other neurologic disorders and 28 age-matched healthy volunteers tested negative for reactivity to anti-neutral glycolipid antibodies.

CONCLUSION:

The resolution of radiologic and neurologic abnormalities and altered autoantibody titers against neutral glycolipids after immunotherapy suggest that EMRN is caused by an immune-mediated mechanism. These autoantibodies may be useful biomarkers for EMRN.

PMID:
24319040
[PubMed - indexed for MEDLINE]
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