Prevalence of anti-ganglioside antibodies and their clinical correlates with guillain-barré syndrome in Korea: a nationwide multicenter study.
OBJECTIVE
No previous studies have investigated the relationship between various anti-ganglioside antibodies and the clinical characteristics of Guillain-Barré syndrome (GBS) in Korea. The aim of this study was to determine the prevalence and types of anti-ganglioside antibodies in Korean GBS patients, and to identify their clinical significance.


METHODS
Serum was collected from patients during the acute phase of GBS at 20 university-based hospitals in Korea. The clinical and laboratory findings were reviewed and compared with the detected types of anti-ganglioside antibody.


RESULTS
Among 119 patients, 60 were positive for immunoglobulin G (IgG) or immunoglobulin M antibodies against any type of ganglioside (50%). The most frequent type was IgG anti-GM1 antibody (47%), followed by IgG anti-GT1a (38%), IgG anti-GD1a (25%), and IgG anti-GQ1b (8%) antibodies. Anti-GM1-antibody positivity was strongly correlated with the presence of preceding gastrointestinal infection, absence of sensory symptoms or signs, and absence of cranial nerve involvement. Patients with anti-GD1a antibody were younger, predominantly male, and had more facial nerve involvement than the antibody-negative group. Anti-GT1a-antibody positivity was more frequently associated with bulbar weakness and was highly associated with ophthalmoplegia when coupled with the coexisting anti-GQ1b antibody. Despite the presence of clinical features of acute motor axonal neuropathy (AMAN), 68% of anti-GM1- or anti-GD1a-antibody-positive cases of GBS were diagnosed with acute inflammatory demyelinating polyradiculoneuropathy (AIDP) by a single electrophysiological study.


CONCLUSIONS
Anti-ganglioside antibodies were frequently found in the serum of Korean GBS patients, and each antibody was correlated strongly with the various clinical manifestations. Nevertheless, without an anti-ganglioside antibody assay, in Korea AMAN is frequently misdiagnosed as AIDP by single electrophysiological studies.
Department of Neurology, College of Medicine, Dong-A University, Busan, Korea.
Jong Kuk
JK
Kim
Department of Neurology, College of Medicine, Hallym University, Seoul, Korea.
Jong Seok
JS
Bae
Department of Neurology, School of Medicine, Pusan National University, Busan, Korea.
Dae-Seong
DS
Kim
Department of Neurology, School of Medicine, Kinki University, Osaka, Japan.
Susumu
S
Kusunoki
Department of Industrial and Occupational Medicine, Pusan National University School of Medicine, Busan, Korea.
Jong Eun
JE
Kim
Department of Neurology, College of Medicine, Seoul National University, Seoul, Korea.
Ji Soo
JS
Kim
Department of Neurology, School of Medicine, Pusan National University, Busan, Korea.
Young-Eun
YE
Park
Department of Neurology, School of Medicine, Gyeongsang National University, Jinju, Korea.
Ki-Jong
KJ
Park
Department of Neurology, School of Medicine, Kyungpook National University, Daegu, Korea.
Hyun Seok
HS
Song
Department of Neurology, College of Medicine, University of Ulsan, Ulsan, Korea.
Sun Young
SY
Kim
Department of Neurology, School of Medicine, Keimyung University, Daegu, Korea.
Jeong-Geun
JG
Lim
Department of Neurology, College of Medicine, Dongguk University, Seoul, Korea.
Nam-Hee
NH
Kim
Department of Neurology, School of Medicine, Sungkyunkwan University, Seoul, Korea.
Bum Chun
BC
Suh
Department of Neurology, Chonnam National University Medical School, Gwangju, Korea.
Tai-Seung
TS
Nam
Department of Neurology, School of Medicine, Yeungnam University, Daegu, Korea.
Min Su
MS
Park
Department of Neurology, College of Medicine, Yonsei University, Seoul, Korea.
Young-Chul
YC
Choi
Department of Neurology, School of Medicine, Chungnam National University, Daejeon, Korea.
Eun Hee
EH
Sohn
Department of Neurology, College of Medicine, Konyang University, Daejeon, Korea.
Sang-Jun
SJ
Na
Department of Neurology, College of Medicine, Kosin University, Busan, Korea.
So Young
SY
Huh
Department of Neurology, School of Medicine, Eulji University, Seoul, Korea.
Ohyun
O
Kwon
Department of Neurology, College of Medicine, Dong-A University, Busan, Korea.
Su-Yun
SY
Lee
Department of Neurology, College of Medicine, Hallym University, Seoul, Korea.
Sung-Hoon
SH
Lee
Department of Neurology, School of Medicine, Chonbuk National University, Jeonju, Korea.
Sun-Young
SY
Oh
Department of Neurology, School of Medicine, Chungnam National University, Daejeon, Korea.
Seong-Hae
SH
Jeong
Department of Neurology, College of Medicine, Soonchunhyang University, Seoul, Korea.
Tae-Kyeong
TK
Lee
Department of Neurology, School of Medicine, Chosun University, Gwangju, Korea.
Dong Uk
DU
Kim
Guillain-Barré syndrome; Korea; acute motor axonal neuropathy; antibodies; ganglioside