Prevalence of Anti-Ganglioside Antibodies and Their Clinical Correlates with Guillain-Barré Syndrome in Korea: A Nationwide Multicenter Study

• Published in: Journal of clinical neurology (Seoul, Korea) Vol. 10; no. 2; pp. 94 - 100
• Main Authors: 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, Huh, So Young, Kwon, Ohyun, Lee, Su-Yun, Lee, Sung-Hoon, Oh, Sun-Young, Jeong, Seong-Hae, Lee, Tae-Kyeong, Kim, Dong Uk
• Format: Journal Article
• Language: English
• Published: Korea (South) Korean Neurological Association 01.04.2014; 대한신경과학회
• Subjects: Original; 신경과학; antibodies; acute motor axonal neuropathy; Guillain-Barré syndrome; ganglioside; Korea
• ISSN: 1738-6586; 2005-5013
• DOI: 10.3988/jcn.2014.10.2.94

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. 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. 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. 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.