Anti‐GalNAc‐GD1a antibody–associated Guillain‐Barré syndrome with a predominantly distal weakness without cranial nerve impairment and sensory disturbance
Anti‐GalNAc‐GD1a antibody–associated Guillain‐Barré syndrome with a predominantly distal weakness without cranial nerve impairment and sensory disturbance
复制标题
抗 GalNAc-GD1a 抗体相关的格林-巴利综合征，主要表现为远端无力，无脑神经损伤和感觉障碍
作者：
Q. Hao;T. Saida;H. Yoshino;S. Kuroki;M. Nukina;K. Saida
在147例格林-巴利综合征（GBS）患者中测定了N-乙酰半乳糖胺GD 1a（GalNAc-GD 1a）和其他神经节苷脂以及空肠弯曲菌的血清抗体。我们发现，与没有抗体的患者相比，有抗GalNAc-GD 1a抗体的患者具有独特的临床模式，即无颅神经受累（87%对38%），远端优势肌无力（80%对25%）和无感觉障碍（73%对22%）。空肠弯曲菌感染和抗GalNAc-GD 1a阳性患者（100%）的远端优势肌无力频率显著高于空肠弯曲菌阴性/抗GalNAc-GD 1a阳性（25%）、空肠弯曲菌阳性/抗GalNAc-GD 1a阴性（32%）和空肠弯曲菌阴性/抗GalNAc-GD 1a阴性患者（20%）。在大多数空肠梭菌阳性/抗GalNAc-GD 1a阳性和空肠梭菌阴性/抗GalNAc-GD 1a阳性患者中未发现颅神经受累和感觉障碍，但在空肠梭菌阳性/抗GalNAc-GD 1a阴性和空肠梭菌阴性/抗GalNAc-GD 1a阴性患者中未发现颅神经受累和感觉障碍。虽然抗GM 1阳性/抗GalNAc-GD 1a阴性患者大多数（75%）无颅神经受累，但远端优势肌无力（38%）和无感觉障碍（13%）并不常见。这些结果可能表明：（1）空肠弯曲菌感染和抗GalNAc-GD 1a抗体的组合，而非抗GalNAc-GD 1a、抗GM 1或单独的空肠弯曲菌感染，与主要远端无力相关;（2）抗GalNAc-GD 1a而非空肠弯曲菌感染或抗GM 1抗体的存在与感觉障碍的缺乏相关，（3）抗GalNAc-GD 1a和抗GM 1抗体均与无颅神经损伤独立相关。《神经学年鉴》1999;45：758-768
The serum antibodies to N‐acetylgalactosaminyl GD1a (GalNAc‐GD1a) and other gangliosides as well as to Campylobacter jejuni were determined in 147 patients with Guillain‐Barré syndrome (GBS). We found a distinctive clinical pattern in patients with anti‐GalNAc‐GD1a antibodies compared with those without the antibodies, that is, lack of cranial nerve involvement (87% versus 38%), distal‐dominant weakness (80% versus 25%), and no sensory disturbance (73% versus 22%). The frequency of distal‐dominant weakness was significantly higher in patients with both C jejuni infection and anti‐GalNAc‐GD1a positivity (100%) than in C jejuni–negative/anti‐GalNAc‐GD1a–positive (25%), C jejuni–positive/anti‐GalNAc‐GD1a–negative (32%) and C jejuni–negative/anti‐GalNAc‐GD1a–negative patients (20%). Lack of cranial nerve involvement and sensory disturbance were found in most C jejuni–positive/anti‐GalNAc‐GD1a–positive and C jejuni–negative/anti‐GalNAc‐GD1a–positive patients, but not in C jejuni–positive/anti‐GalNAc‐GD1a–negative and C jejuni–negative/anti‐GalNAc‐GD1a–negative patients. Although the anti‐GM1–positive/anti‐GalNAc‐GD1a–negative patients mostly (75%) lacked cranial nerve involvement, distal‐dominant weakness (38%) and lack of sensory disturbance (13%) were infrequent. These results may indicate that (1) the combination of C jejuni infection and anti‐GalNAc‐GD1a antibodies, but not anti‐GalNAc‐GD1a, anti‐GM1, or C jejuni infection alone, is associated with a predominantly distal weakness, (2) the presence of anti‐GalNAc‐GD1a, rather than C jejuni infection or anti‐GM1 antibody, is associated with a lack of sensory disturbance, (3) both anti‐GalNAc‐GD1a and anti‐GM1 antibodies are independently associated with a lack of cranial nerve impairment. Ann Neurol 1999;45:758–768
神经节苷脂 GM2、IV4GalNAcGM1b 和 IV4GalNAcGC1a 作为单克隆免疫球蛋白 M 的抗原，治疗与丙种球蛋白病相关的神经病。
DOI：
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发表时间：
1988
期刊：
The Journal of biological chemistry
影响因子：
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作者：
Ilyas,AA;Li,SC;Chou,DK;Li,YT;Jungalwala,FB;Dalakas,MC;Quarles,RH
通讯作者：
Quarles,RH