title: Anti-neutral glycolipid antibodies in encephalomyeloradiculoneuropathy.
abstract: OBJECTIVE
  The aim of this study was to review 4 patients with encephalomyeloradiculoneuropathy (EMRN) and assess for autoantibodies against neutral glycolipids.
  
  
  METHODS
  We studied the progression of clinical, radiologic, neurophysiologic, and CSF findings, as well as anti-neutral glycolipid antibodies in sera.
  
  
  RESULTS
  All patients developed acute or subacute motor weakness and impaired consciousness. Their CSF showed pleocytosis and high immunoglobulin G concentrations. MRI revealed lesions in the brain and spinal cord. Neurophysiologic examinations indicated dysfunction of the spinal cord, nerve roots, and peripheral nerves. Steroid pulsed immunotherapy and/or high dose of IV immunoglobulin replacement therapy resulted in clear and often dramatic clinical improvements. Reactivity to anti-neutral glycolipid antibodies was positive in all patients with acute EMRN but not in the recovery phase. Forty-seven age-matched patients with other neurologic disorders and 28 age-matched healthy volunteers tested negative for reactivity to anti-neutral glycolipid antibodies.
  
  
  CONCLUSIONS
  The resolution of radiologic and neurologic abnormalities and altered autoantibody titers against neutral glycolipids after immunotherapy suggest that EMRN is caused by an immune-mediated mechanism. These autoantibodies may be useful biomarkers for EMRN.
authors: From the Department of Neurology (S.S., N.K., T.I., Y.N., A.U., T.M.), Fujita Health University School of Medicine, Aichi; and Institute for Environmental and Gender Specific Medicine (H.M., C.I., K.I.), Juntendo University Graduate School of Medicine, Chiba, Japan.
authors: Sayuri
authors: S
authors: Shima
authors: Naoki
authors: N
authors: Kawamura
authors: Tomomasa
authors: T
authors: Ishikawa
authors: Hiromi
authors: H
authors: Masuda
authors: Chihiro
authors: C
authors: Iwahara
authors: Yoshiki
authors: Y
authors: Niimi
authors: Akihiro
authors: A
authors: Ueda
authors: Kazuhiza
authors: K
authors: Iwabuchi
authors: Tatsuro
authors: T
authors: Mutoh
mesh_terms: D000328:Adult; D000368:Aged; D000906:Antibodies / Q000032:analysis*; D001323:Autoantibodies / Q000032:analysis; D001921:Brain / Q000000981:diagnostic imaging / Q000473:pathology; D005073:Evoked Potentials, Somatosensory / Q000502:physiology; D005158:Facial Paralysis / Q000209:etiology; D005260:Female; D006028:Glycosphingolipids / Q000276:immunology*; D006801:Humans; D015151:Immunoblotting; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D018908:Muscle Weakness / Q000209:etiology; D009431:Neural Conduction; D009460:Neurologic Examination; D020277:Polyradiculoneuropathy, Chronic Inflammatory Demyelinating / Q000000981:diagnostic imaging / Q000276:immunology* / Q000628:therapy; D013116:Spinal Cord / Q000473:pathology; D020349:Surface Plasmon Resonance; D015899:Tomography, Emission-Computed, Single-Photon; D016896:Treatment Outcome
chemical_list: D000906:Antibodies; D001323:Autoantibodies; D006028:Glycosphingolipids; D016756:Immunoglobulins, Intravenous