항 강글리오사이드 항체 양성인 환자의 임상적 특성

Abstract

Objectives Guillain-Barré syndrome (GBS) is an acute autoimmune demyelinating inflammatory polyneuropathy from which most patients ultimately recover satisfactorily. GBS can be classified with several subtypes along with the union of each symptom. Autoimmune mechanism is accepted for pathogenesis of GBS, several anti-ganglioside autoantibodies can be detected in the serum of patients with GBS. It is often difficult to predict the causative antibodies of the various types of the GBS, because there are considerable mismatches of causative antibody to clinical phenotype as well as phenotype or antibody heterogeneities. We described the clinical characteristics of the patients with positivity of anti-gangliosides antibody in the serum.

Methods Nineteen consecutive patients were enrolled who showed the positivity of anti-GM1 antibody, anti-GQ1b antibody and anti-GD1b antibody in his or her serum, who had visited the department of neurology of Chosun University Hospital. We reviewed the medical records previous published reports and listed the clinical characteristics and laboratory data.

Results Mean age was 53 years old and common symptoms or signs were gait disturbance, decreased tendon reflex and limb weakness. About a quarter of patients had needed for assisted ventilation. We classified the three patient groups; 8 patients had positivity for anti-GM1 antibody, 10 patients for anti-GQ1b antibody and 8 patients for GD1b antibody. The result of statistical analysis showed no clinical difference within the groups.

Conclusion We assumed the existence of mismatches of phenotypes to subtypes of autoantidbody. To our knowledge, the prediction of causative autoantibody can be risky when we considered only the symptoms and course of disease of GBS.

KEY WORDS : GBS, anti-gangliosides antibody