Clinical correlates of serum anti-GT1a IgG antibodies
Clinical correlates of serum anti-GT1a IgG antibodies
复制标题
DOI：
10.1016/j.jns.2004.01.005
复制
发表时间：
2004-04-15
影响因子：
4.4
通讯作者：
Yuki, N
中科院分区：
文献类型：
--
作者：
Nagashima, T;Koga, M;Yuki, N
格林-巴利综合征（GBS）的咽-颈-臂变异型（PCB）患者具有抗GT 1a IgG，伴或不伴GQ 1b反应，而Fisher综合征（FS）或Bickerstaff脑干脑炎（BBE）患者具有与GT 1a交叉反应的抗GQ 1b IgG抗体。这些疾病之间的疾病分类关系尚未确定。为了研究每种表现之间的关系和临床特征与抗GQ 1b IgG的共存之间的关系，我们回顾了140例患有抗GT 1a IgG的患者在疾病期间出现的神经系统体征。根据我们的标准，64例（46%）患者被诊断为FS，22例（16%）患者被诊断为GBS，14例（10%）患者被诊断为BBE，6例（4%）患者被诊断为PCB。一些患者被诊断为重叠疾病：FS和GBS（5%），PCB和FS（5%），BBE和GBS（4%），PCB和BBE（1%）。最初患有球麻痹的患者不仅发展为PCB，还发展为FS或BBE。抗GT 1a阳性患者人群经常有眼肌麻痹、共济失调和反射消失，而抗GT 1a IgG无GQ 1b反应的亚群经常有腹泻以及口咽、颈部和四肢无力。抗GT 1a IgG患者表现出多种临床状况，表明具有连续的临床谱。该临床变异的主要原因是抗GQ 1b IgG的共存。常见自身抗体（抗GT 1a IgG）和重叠疾病的存在表明，PCB不仅与GBS密切相关，而且与FS和BBE也密切相关。(C)2004 Elsevier B. V.保留所有权利。
Patients with the pharyngeal-cervical-brachial variant (PCB) of Guillain-Barre syndrome (GBS) have anti-GT1a IgG with or without GQ1b reactivity, whereas those with Fisher syndrome (FS) or Bickerstaff's brainstem encephalitis (BBE) have anti-GQ1b IgG antibodies which cross-react with GT1a. The nosological relationship between these conditions has yet to be established. To investigate the relationships between each manifestation and between clinical features and the coexistence of anti-GQ1b IgG, we reviewed neurological signs present during illnesses of 140 patients who had anti-GT1a IgG. Based on our criteria, FS was diagnosed for 64 (46%) patients, GBS for 22 (16%), BBE for 14 (10%), and PCB for 6 (4%). Overlapping conditions were diagnosed for some patients: FS and GBS (5%), PCB and FS (5%), BBE and GBS (4%), and PCB and BBE (1%). Patients who initially had bulbar palsy developed not only PCB but FS or BBE. The population of anti-GT1a-positive patients frequently had ophthalmoplegia, ataxia, and areflexia, whereas the subpopulation who had anti-GT1a IgG without GQ1b reactivity frequently had preceding diarrhea as well as oropharyngeal, neck, and limb weakness. Patients with anti-GT1a IgG presented a variety of clinical conditions, indicative of a continuous clinical spectrum. A major part of this clinical variation was due to the coexistence of anti-GQ1b IgG. The presence of a common autoantibody (anti-GT1a IgG) and overlapping illnesses suggests that PCB is closely related not only to GBS but to FS and BBE as well. (C) 2004 Elsevier B.V. All rights reserved.