Two patterns of clinical recovery in Guillain-Barré syndrome with IgG anti-GM1 antibody.
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.
Kuwabara
S
S
Department of Neurology, Chiba University School of Medicine, Japan.
Asahina
M
M
Koga
M
M
Mori
M
M
Yuki
N
N
Hattori
T
T
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
D007074:Immunoglobulin G; D005677:G(M1) Ganglioside