[A case of pharyngeal-cervical-brachial variant of Guillain-Barré syndrome with positive anti-galactocerebroside (Gal-C) IgM antibody].
A 49-year-old man presented with hoarseness, dysphagia, muscle atrophy and weakness of deltoid, trapezius, sternocleidomastoid, rhomboid, anterior serratus, infraspinatus and supraspinatus. Anti-Gal-C IgM antibody was positive in the serum. The other antiganglioside antibodies (GM1, GM2, GM3, GD1a, GD1b, GD3, GT1a, GT1b, GQ1b, GA1, GalNAc-GD1a, GM1b) were negative. Patient contracted pneumonia but whether it was due to mycoplasma was not evident. Plasmapheresis improved his clinical state including a decrease of the antibody. This case was diagnosed pharyngeal-cervical-brachial variant of Guillain-Barré syndrome, and anti-Gal-C antibody seemed to be correlated with the pathogenesis of this syndrome. Gal-C is a major glycolipid of myelin and the cell membrane of the myelin-forming cell (oligodendrocytes and Schwann cells) and is free of specific localization and distribution. The mechanism how the anti-Gal-C IgM antibody induced bulbar paralysis and the symptoms localizing neck and upper limbs remains to be known.
Kasuya
J
J
Third Department of Internal Medicine, Kagoshima University School of Medicine.
Miyazono
T
T
Takenaga
S
S
Arimura
K
K
Osame
M
M
Kusunoki
S
S
D001323:Autoantibodies / Q000097:blood*; D005699:Galactosylceramides / Q000276:immunology*; D006801:Humans; D007075:Immunoglobulin M / Q000097:blood*; D008297:Male; D008875:Middle Aged; D010956:Plasmapheresis; D011129:Polyradiculoneuropathy / Q000145:classification / Q000276:immunology* / Q000628:therapy
D001323:Autoantibodies; D005699:Galactosylceramides; D007075:Immunoglobulin M; C002454:galactocerebroside