Title: Clinical features and response to treatment in Guillain-Barr� syndrome associated with antibodies to GM1b ganglioside
Abstract: Annals of NeurologyVolume 47, Issue 3 p. 314-321 Original Article Clinical features and response to treatment in Guillain-Barré syndrome associated with antibodies to GM1b ganglioside Nobuhiro Yuki MD, PhD, Corresponding Author Nobuhiro Yuki MD, PhD Department of Neurology, Dokkyo University School of Medicine, Tochigi, JapanDepartment of Neurology, Dokkyo University School of Medicine, Kitakobayashi 880, Mibu, Shimotsuga, Tochigi 321-0293, JapanSearch for more papers by this authorC. Wim Ang MD, C. Wim Ang MD Department of Neurology, Erasmus Medical Center, Rotterdam, The Netherlands Department of Immunology, Erasmus Medical Center, Rotterdam, The NetherlandsSearch for more papers by this authorMichiaki Koga MD, PhD, Michiaki Koga MD, PhD Department of Neurology, Dokkyo University School of Medicine, Tochigi, JapanSearch for more papers by this authorBart C. Jacobs MD, PhD, Bart C. Jacobs MD, PhD Department of Neurology, Erasmus Medical Center, Rotterdam, The Netherlands Department of Immunology, Erasmus Medical Center, Rotterdam, The NetherlandsSearch for more papers by this authorPieter A. Van Doorn MD, PhD, Pieter A. Van Doorn MD, PhD Department of Neurology, Erasmus Medical Center, Rotterdam, The NetherlandsSearch for more papers by this authorKoichi Hirata MD, PhD, Koichi Hirata MD, PhD Department of Neurology, Dokkyo University School of Medicine, Tochigi, JapanSearch for more papers by this authorFrans G. A. Van Der Meché MD, PhD, Frans G. A. Van Der Meché MD, PhD Department of Neurology, Erasmus Medical Center, Rotterdam, The NetherlandsSearch for more papers by this author Nobuhiro Yuki MD, PhD, Corresponding Author Nobuhiro Yuki MD, PhD Department of Neurology, Dokkyo University School of Medicine, Tochigi, JapanDepartment of Neurology, Dokkyo University School of Medicine, Kitakobayashi 880, Mibu, Shimotsuga, Tochigi 321-0293, JapanSearch for more papers by this authorC. Wim Ang MD, C. Wim Ang MD Department of Neurology, Erasmus Medical Center, Rotterdam, The Netherlands Department of Immunology, Erasmus Medical Center, Rotterdam, The NetherlandsSearch for more papers by this authorMichiaki Koga MD, PhD, Michiaki Koga MD, PhD Department of Neurology, Dokkyo University School of Medicine, Tochigi, JapanSearch for more papers by this authorBart C. Jacobs MD, PhD, Bart C. Jacobs MD, PhD Department of Neurology, Erasmus Medical Center, Rotterdam, The Netherlands Department of Immunology, Erasmus Medical Center, Rotterdam, The NetherlandsSearch for more papers by this authorPieter A. Van Doorn MD, PhD, Pieter A. Van Doorn MD, PhD Department of Neurology, Erasmus Medical Center, Rotterdam, The NetherlandsSearch for more papers by this authorKoichi Hirata MD, PhD, Koichi Hirata MD, PhD Department of Neurology, Dokkyo University School of Medicine, Tochigi, JapanSearch for more papers by this authorFrans G. A. Van Der Meché MD, PhD, Frans G. A. Van Der Meché MD, PhD Department of Neurology, Erasmus Medical Center, Rotterdam, The NetherlandsSearch for more papers by this author First published: 30 April 2001 https://doi.org/10.1002/1531-8249(200003)47:3<314::AID-ANA6>3.0.CO;2-CCitations: 77AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Abstract GM1b is a minor ganglioside in human peripheral nerves. Serum anti-GM1b antibodies frequently are present in patients with Guillain-Barré syndrome (GBS). In this collaborative study, we investigated the antecedent infections, clinical features, and response to treatment of GBS patients with anti-GM1b antibodies. Of 132 GBS patients who participated in the Dutch GBS trial that compared the effect of intravenous immunoglobulins and plasma exchange, 25 (19%) patients had anti-GM1b antibodies. IgM antibodies were present in 14, IgG antibodies in 15, and both isotypes in 4 patients. The 25 patients with anti-GM1b antibodies had a clinical pattern distinct from that of the other 107 GBS patients. They more often had an episode of gastrointestinal illness and frequently showed serological evidence of recent infection by Campylobacter jejuni. The anti-GM1b–positive subgroup was marked by more rapidly progressive, more severe, and predominantly distal weakness. Cranial nerve involvement and sensory deficits were less common in the patients with anti-GM1b antibodies. The presence of anti-GM1b antibodies was associated with slower recovery. The clinical manifestations predominantly were associated with anti-GM1b antibodies of the IgG isotype. Fourteen (56%) of the 25 patients with anti-GM1b antibodies also had anti-GM1 antibodies. The group of patients with both antibodies was clinically more homogeneous and had a more rapidly progressive, pure motor neuropathy. The subgroup of anti-GM1b–positive GBS patients responded well to treatment with immunoglobulins but not to plasmapheresis. The distinctive clinical features of the patients with anti-GM1b antibodies show that acute motor neuropathy represents a specific subgroup within GBS and that recognizing these patients may have consequences as to the choice of therapy. Ann Neurol 2000;47:314–321 Citing Literature Volume47, Issue3March 2000Pages 314-321 RelatedInformation
Publication Year: 2000
Publication Date: 2000-03-01
Language: en
Type: article
Indexed In: ['crossref']
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Cited By Count: 87
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