[A case of Guillain-Barré syndrome with bulbar palsy showing the elevations of the anti-GD1a and GT1b antibodies].
We reported a 44-year-old woman with Guillain-Barré syndrome (GBS) showing elevations of serum anti-GD1a and anti-GT1b antibody levels. A few days after an upper respiratory infection, she felt numbness in her hands and feet, dysphagia and dysarthria, and weakness in her limbs. On admission, examination showed the paralysis of pharynx and neck, moderate weakness of face and upper limbs, and mild weakness of lower limbs. Sensory deficits were minimal on the distal side of extremities. Deep reflexes were decreased or absent. Laboratory examinations revealed the albumino-cytological dissociation in cerebrospinal fluid and the increase of anti-GD1a and anti-GT1b antibodies in serum. Nerve conduction studies demonstrated axonal damage to the motor nerves. With immunoadsorption therapy, she gradually recovered and the anti-GD1a and anti-GT1b antibodies were normalized. It was reported that the anti-GT1a antibody may be associated with a pharyngeal-cervical-brachial (PCB) variant of GBS (Ropper) and the similar cases including the present case. However, in the present case, the serum anti-GT1a antibody level was not increased, whereas those of anti-GD1a and anti-GT1b antibodies did. Therefore, these antibodies may also play a role in the development of PCB signs in GBS.
Ito
S
S
Department of Neurology, Toyohashi Municipal Hospital.
Hirose
Y
Y
Mokuno
K
K
Kusunoki
S
S
D000328:Adult; D001323:Autoantibodies / Q000097:blood*; D010244:Bulbar Palsy, Progressive / Q000276:immunology* / Q000628:therapy; D005260:Female; D005732:Gangliosides / Q000276:immunology*; D020275:Guillain-Barre Syndrome / Q000276:immunology* / Q000628:therapy; D006801:Humans; D007163:Immunosorbent Techniques; D016896:Treatment Outcome
D001323:Autoantibodies; D005732:Gangliosides; C021298:ganglioside, GD1a; C016481:trisialoganglioside GT1