Antiganglioside Antibodies in Sub Types of Guillain-Barre Syndrome in an Indian Population

摘要

Antiganglioside antibody tests for immune-mediated neuropathy are now widely available. They can identify subsets of patients within the large group of idiopathic neuropathies that have lacked specific clinical definition. The aim was to study the subtypes of Guillian Barre Syndrome based on the presence of type of antiganglioside antibodies and to correlate these with the clinical features. Sera from 73 patients with GBS which included the subtypes of Acute Inflammatory Demyelinating Polyneuropathy (AIDP), Acute Motor Axonal Neuropathy (AMAN), acute motor and sensory axonal neuropathy (AMSAN) and Miller Fisher Syndrome (MFS) were examined for the presence of IgG and IgM (GM1, GM2, GM3, GD1A, GD1B, GT1B, GQ1B) antiganglioside antibodies using qualitative in vitro kit. In GBS, IgG GM1 (59%) and IgM GM1(25%) were positive in maximum number of cases. In subgroup AMAN, IgG (GM1 and GD1B) were positive in 53% of cases, IgM GM1 was positive in 50% of cases. Two patients of AMAN who had a previous history of gastroenteritis were positive for all IgG antibodies. In the subgroup AIDP, IgG GT1B and IgM GM1 were positive in 28 and 18%, respectively. Multiple types of antiganglioside antibodies were associated with the subtypes of GBS in the population from South India. AMAN variant was commonly associated with antibodies as compared to other variants. Antibodies associated with subtype AMAN were IgG GM1, GD1B and IgM GM1. AIDP variant was associated with IgG GT1B and IgM GM1. The assay may be useful for rapid screening of GBS sera for antibodies to multiple gangliosides.