Serologic marker of acute motor axonal neuropathy in childhood.
Guillain-Barré syndrome is divided into two subtypes: acute inflammatory demyelinating polyneuropathy, and acute motor axonal neuropathy. Autoantibodies to gangliosides GM1, GM1b, GD1a, or GalNAc-GD1a were proposed as serologic markers of acute motor axonal neuropathy in adults. In a previous study of Japanese children with Guillain-Barré syndrome, acute motor axonal neuropathy was associated with anti-GM1 immunoglobulin G antibodies. Larger, comprehensive studies are required to confirm this finding. The present study revealed that immunoglobulin G antibodies were against GM1 (34%), GM1b (22%), GD1a (25%), GalNAc-GD1a (13%), and any of these (44%) in 32 Japanese children with Guillain-Barré syndrome. Patients who had the autoantibodies more often manifested previous diarrhea (71% vs 11%, P = 0.001), acute motor axonal neuropathy (64% vs 11%, P = 0.003), and slower recovery (healthy at final follow-up: 29% vs 78%, P = 0.011; able to run with minor signs, 64% vs 11%, P = 0.003) than patients who did not. The clinical features were consistent with those in adults carrying anti-ganglioside antibodies. Anti-ganglioside antibody testing may help predict outcomes in pediatric patients with Guillain-Barré syndrome who prefer not to undergo repeated nerve-conduction studies.
Department of Pediatrics, Nanki Fukushi Center, Wakayama, Japan.
Yukihiro
Y
Nishimoto
Keiichiro
K
Susuki
Nobuhiro
N
Yuki
D000293:Adolescent; D001323:Autoantibodies / Q000097:blood; D001369:Axons / Q000473:pathology*; D015415:Biomarkers / Q000097:blood; D002169:Campylobacter Infections / Q000276:immunology; D016123:Campylobacter jejuni / Q000276:immunology; D002648:Child; D002675:Child, Preschool; D004568:Electrodiagnosis; D004569:Electroencephalography; D005260:Female; D005732:Gangliosides / Q000276:immunology; D020275:Guillain-Barre Syndrome / Q000097:blood* / Q000473:pathology*; D006801:Humans; D007136:Immunoglobulins / Q000097:blood; D007223:Infant; D008297:Male; D011379:Prognosis
D001323:Autoantibodies; D015415:Biomarkers; D005732:Gangliosides; D007136:Immunoglobulins