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Neuromuscular
Short report
Clonality of anti-GM1 IgM antibodies in multifocal motor neuropathy and the Guillain-Barré syndrome
  1. Elisabeth A Cats1,
  2. W-Ludo van der Pol1,
  3. Anne P Tio-Gillen2,
  4. Frank P Diekstra1,
  5. Leonard H van den Berg1,
  6. Bart C Jacobs2
  1. 1Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
  2. 2Department of Neuroimmunology, The Erasmus University Medical Center, Rotterdam, The Netherlands
  1. Correspondence to Dr Elisabeth A Cats, Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus, University Medical Center Utrecht, Heidelberglaan 100, Utrecht 3584 CX, The Netherlands; e.cats{at}umcutrecht.nl

Abstract

Objective Multifocal motor neuropathy (MMN) and the Guillain-Barré syndrome (GBS) are immune-mediated motor neuropathies with antibodies against the ganglioside GM1. In GBS, these antibodies are induced by molecular mimicry, but in MMN their origin is elusive.

Methods We compared the light-chain use of anti-GM1 IgM antibodies in serum from 42 patients with MMN and 23 patients with GBS by ELISA.

Results Exclusive use of either κ or λ light chains was found in 38 (90%) patients with MMN and 9 (39%) with GBS (p<0.001).

Conclusions Anti-GM1 IgM antibodies in most patients with MMN are produced by only a single or very limited number of B-cell clones, whereas in most patients with GBS, anti-GM1 IgM antibodies are most likely polyclonal.

  • GUILLAIN-BARRE SYNDROME
  • NEUROPATHY

http://dx.doi.org/10.1136/jnnp-2014-308118

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