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IgG Anti-GT1a antibodies which do not cross react with GQ1b ganglioside in a pharyngeal-cervical-brachial variant of Guillain-Barré syndrome
  1. KENICHI KASHIHARA,
  2. YOSHIHIKO SHIRO
  1. Department of Neurology, Okayama University Medical School, Okayama, Japan
  2. Department of Neurology, Dokkyo University School of Medicine, Tochigi, Japan
  1. Dr K Kashihara, Department of Neurology, Okayama University Medical School, 2–5–1 Shikata-cho, Okayama 700–0914, Japan.
  1. MICHIAKI KOGA,
  2. NOBUHIRO YUKI
  1. Department of Neurology, Okayama University Medical School, Okayama, Japan
  2. Department of Neurology, Dokkyo University School of Medicine, Tochigi, Japan
  1. Dr K Kashihara, Department of Neurology, Okayama University Medical School, 2–5–1 Shikata-cho, Okayama 700–0914, Japan.

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IgG anti-GT1a antibody which cross reacts with GQ1b ganglioside is associated with ophthalmoplegia in Guillain-Barré syndrome and in Fisher’s syndrome, a variant of Guillain-Barré syndrome.1 Pharyngeal-cervical-brachial weakness is another regional variant of Guillain-Barré syndrome originally described by Ropper.2 Its symptoms resemble those of botulism and diphtheria and are characterised by marked oropharyngeal, neck, and shoulder weakness with areflexia only in the arms. We report on a patient with this variant who had high titres of serum IgG anti-GT1a antibody which did not cross react with GQ1b.

Thin layer chromatography with immunostaining. Thin layer chromatography plates stained with (A) orcinol/sulphuric acid for hexose; (B) IgG from our patient, subsequently stained by peroxidase conjugated antihuman IgG antibodies; (C) IgG from a patient with Bickerstaff’s brain stem encephalitis. Lane 1: bovine brain ganglioside mixtures. Lane 2: the GD1a and GT1a fraction separated from bovine brain ganglioside mixtures by Q-sepharose column chromatography. Lane 3: fraction enriched with GT1a and GQ1b. The plates were developed with C-M-0.2% calcium chloride in water (5:4:1 by volume).

A 55 year-old woman was admitted due to sudden onset ptosis, trouble with swallowing, and nausea and vomiting. One week before admission she had had an upper respiratory infection with diarrhoea which lasted for several days. On admission, …

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