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J Clin Neurol. 2014 Apr;10(2):94-100. doi: 10.3988/jcn.2014.10.2.94. Epub 2014 Apr 23.

Prevalence of anti-ganglioside antibodies and their clinical correlates with guillain-barré syndrome in Korea: a nationwide multicenter study.

Author information

1
Department of Neurology, College of Medicine, Dong-A University, Busan, Korea.
2
Department of Neurology, College of Medicine, Hallym University, Seoul, Korea.
3
Department of Neurology, School of Medicine, Pusan National University, Busan, Korea.
4
Department of Neurology, School of Medicine, Kinki University, Osaka, Japan.
5
Department of Industrial and Occupational Medicine, Pusan National University School of Medicine, Busan, Korea.
6
Department of Neurology, College of Medicine, Seoul National University, Seoul, Korea.
7
Department of Neurology, School of Medicine, Gyeongsang National University, Jinju, Korea.
8
Department of Neurology, School of Medicine, Kyungpook National University, Daegu, Korea.
9
Department of Neurology, College of Medicine, University of Ulsan, Ulsan, Korea.
10
Department of Neurology, School of Medicine, Keimyung University, Daegu, Korea.
11
Department of Neurology, College of Medicine, Dongguk University, Seoul, Korea.
12
Department of Neurology, School of Medicine, Sungkyunkwan University, Seoul, Korea.
13
Department of Neurology, Chonnam National University Medical School, Gwangju, Korea.
14
Department of Neurology, School of Medicine, Yeungnam University, Daegu, Korea.
15
Department of Neurology, College of Medicine, Yonsei University, Seoul, Korea.
16
Department of Neurology, School of Medicine, Chungnam National University, Daejeon, Korea.
17
Department of Neurology, College of Medicine, Konyang University, Daejeon, Korea.
18
Department of Neurology, College of Medicine, Kosin University, Busan, Korea.
19
Department of Neurology, School of Medicine, Eulji University, Seoul, Korea.
20
Department of Neurology, School of Medicine, Chonbuk National University, Jeonju, Korea.
21
Department of Neurology, College of Medicine, Soonchunhyang University, Seoul, Korea.
22
Department of Neurology, School of Medicine, Chosun University, Gwangju, Korea.

Abstract

BACKGROUND AND PURPOSE:

No previous studies have investigated the relationship between various anti-ganglioside antibodies and the clinical characteristics of Guillain-Barré 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.

KEYWORDS:

Guillain-Barré syndrome; Korea; acute motor axonal neuropathy; antibodies; ganglioside

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