Premium
Axonal Guillain‐Barré syndrome: Relation to anti‐ganglioside antibodies and Campylobacter jejuni infection in Japan
Author(s) -
Ogawara Kazue,
Kuwabara Satoshi,
Mori Masahiro,
Hattori Takamichi,
Koga Michiaki,
Yuki Nobuhiro
Publication year - 2000
Publication title -
annals of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.764
H-Index - 296
eISSN - 1531-8249
pISSN - 0364-5134
DOI - 10.1002/1531-8249(200010)48:4<624::aid-ana9>3.0.co;2-o
Subject(s) - guillain barre syndrome , ganglioside , antibody , immunology , medicine , virology , biology , genetics
To clarify the relations of the axonal form of Guillain‐Barré syndrome (GBS) to anti‐ganglioside antibodies and Campylobacter jejuni infection, 86 consecutive Japanese GBS patients were studied. Electrodiagnostic criteria showed acute inflammatory demyelinating polyneuropathy in 36% of the patients and acute motor axonal neuropathy (AMAN) in 38%. Frequent anti‐ganglioside antibodies were of the IgG class and against GM1 (40%), GD1a (30%), GalNAc‐GD1a (17%), and GD1b (21%). Identified infections were C. jejuni (23%), cytomegalovirus (10%), Mycoplasma pneumoniae (6%), and Epstein‐Barr virus (3%). There was a strong association between AMAN and IgG antibodies against GM1, GD1a, GalNAc‐GD1a, or GD1b. Almost all the patients with at least one of these antibodies had the AMAN pattern or rapid resolution of conduction slowing/block possibly because of early‐reversible changes on the axolemma. C. jejuni infection was frequently associated with AMAN or anti‐ganglioside antibodies, but more than half of the patients with AMAN or anti‐ganglioside antibodies were C. jejuni –negative. These findings suggest that the three phenomena “axonal dysfunctions (AMAN or early‐reversible conduction failure),” “IgG antibodies against GM1, GD1a, GalNAc‐GD1a, or GD1b,” and “ C. jejuni infection” are closely associated but that microorganisms other than C. jejuni frequently trigger an anti‐ganglioside response and elicit axonal GBS. Ann Neurol 2000;48:624–631