title: Two patterns of clinical recovery in Guillain-Barré syndrome with IgG anti-GM1 antibody.
abstract: OBJECTIVE
  To investigate the prognostic value of anti-GM1 antibody.
  
  
  BACKGROUND
  Whether anti-GM1 antibody is a marker of poor prognosis due to axonal degeneration in Guillain-Barré syndrome (GBS) is a matter of controversy.
  
  
  METHODS
  The clinical recovery of 41 consecutive GBS patients was analyzed.
  
  
  RESULTS
  The Hughes functional grading scores were similar at the peak, and 1, 3, and 6 months after onset for the groups of patients with (n=19) and without (n=22) immunoglobulin (Ig) G anti-GM1 antibodies. However, the anti-GM1-positive group included significantly higher proportions of patients with poor recovery (inability to walk independently at 6 months, 5 of 19 versus 0 of 22; p=0.01) and those with a markedly rapid recovery (improvement by two or more Hughes grades within a month, 9 of 19 versus 4 of 22; p=0.05). The positivity of IgG anti-GM1 antibody correlated well with the electrodiagnosis of the acute motor axonal neuropathy pattern but was not always associated with poor prognosis. Anti-GM1-positive patients showed two different patterns of clinical recovery-their conditions improved slower or faster than those of the anti-GM1-negative patients, most of whom had acute inflammatory demyelinating polyneuropathy.
  
  
  CONCLUSIONS
  Anti-GM1 antibody is not always a marker of poor prognosis and, besides axonal degeneration, early reversible effects other than demyelination could be part of the pathophysiology of Guillain-Barré syndrome with IgG anti-GM1 antibody.
authors.affiliation: Department of Neurology, Chiba University School of Medicine, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Kuwabara
authors.forename: M
authors.initials: M
authors.lastname: Asahina
authors.forename: M
authors.initials: M
authors.lastname: Koga
authors.forename: M
authors.initials: M
authors.lastname: Mori
authors.forename: N
authors.initials: N
authors.lastname: Yuki
authors.forename: T
authors.initials: T
authors.lastname: Hattori
mesh_terms: D000328:Adult; D005260:Female; D005677:G(M1) Ganglioside / Q000276:immunology*; D006801:Humans; D007074:Immunoglobulin G / Q000008:administration & dosage*; D007167:Immunotherapy; D008124:Locomotion; D008297:Male; D008875:Middle Aged; D009431:Neural Conduction; D011129:Polyradiculoneuropathy / Q000276:immunology / Q000534:rehabilitation / Q000628:therapy*; D011379:Prognosis; D016896:Treatment Outcome
chemical_list: D007074:Immunoglobulin G; D005677:G(M1) Ganglioside