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KMID : 1130620140100020094
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Journal of Clinical Neurology
2014 Volume.10 No. 2 p.94 ~ p.100
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Prevalence of Anti-Ganglioside Antibodies and Their Clinical Correlates with Guillain-Barre Syndrome in Korea: A Nationwide Multicenter Study
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Kim Jong-Kuk
Bae Jong-Seok
Kim Dae-Seong
Kusunoki Susumu
Kim Jong-Eun
Kim Ji-Soo
Park Young-Eun
Park Ki-Jong
Song Hyun-Seok
Kim Sun-Young
Lim Jeong-Geun
Kim Nam-Hee
Suh Bum-Chun
Nam Tai-Seung
Park Min-Su
Choi Young-Chul
Sohn Eun-Hee
Na Sang-Jun
Huh So-Young
Kwon O-Hyun
Lee Su-Yun
Lee Sung-Hoon
Oh Sun-Young
Jeong Seong-Hae
Lee Tae-Kyeong
Kim Dong-Uk
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Abstract
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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.
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KEYWORD
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Guillain-Barre syndrome, ganglioside, antibodies, Korea, acute motor axonal neuropathy
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