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Neuromuscular
Short report
Serum IgG anti-GD1a antibody and mEGOS predict outcome in Guillain-Barré syndrome
  1. Yuko Yamagishi1,
  2. Motoi Kuwahara1,
  3. Hidekazu Suzuki1,
  4. Masahiro Sonoo2,
  5. Satoshi Kuwabara3,
  6. Takanori Yokota4,
  7. Kyoichi Nomura5,
  8. Atsuro Chiba6,
  9. Ryuji Kaji7,
  10. Takashi Kanda8,
  11. Ken-ichi Kaida5,
  12. Tatsuro Mutoh9,
  13. Ryo Yamasaki10,
  14. Hiroshi Takashima11,
  15. Makoto Matsui12,
  16. Kazutoshi Nishiyama13,
  17. Gen Sobue14,
  18. Susumu Kusunoki1
  1. 1 Department of Neurology, Kindai University Faculty of Medicine, Osakasayama, Osaka, Japan
  2. 2 Department of Neurology, Teikyo University School of Medicine, Itabashi-ku, Tokyo, Japan
  3. 3 Department of Neurology, Chiba University Graduate School of Medicine, Chiba, Chiba, Japan
  4. 4 Department of Neurology, Tokyo Medical and Dental University Faculty of Medicine, Bunkyo-ku, Tokyo, Japan
  5. 5 Department of Neurology, Saitama Medical Center, Kawagoe, Saitama, Japan
  6. 6 Department of Neurology, Kyorin University School of Medicine, Mitaka, Tokyo, Japan
  7. 7 Department of Clinical Neuroscience, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Tokushima, Japan
  8. 8 Department of Neurology and Clinical Neuroscience, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, Japan
  9. 9 Department of Neurology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
  10. 10 Department of Neurology, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
  11. 11 Department of Neurology and Geriatrics, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Kagoshima, Japan
  12. 12 Department of Neurology, Kanazawa Medical University, Kahoku-gun, Ishikawa, Japan
  13. 13 Department of Neurology, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan
  14. 14 Research Division of Dementia and Neurodegenerative Disease, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
  1. Correspondence to Professor Susumu Kusunoki, Department of Neurology, Kindai University Faculty of Medicine, Osaka 589-8511, Japan; kusunoki-tky{at}umin.ac.jp

Abstract

Objective Approximately 15%–20% of patients with Guillain-Barré syndrome (GBS) are unable to walk independently at 6 months from the onset of neurological symptom. The modified Erasmus GBS outcome score (mEGOS) has been reported as a prognostic tool.

Herein we investigated the association between a poor outcome, inability to walk independently at 6 months and presence of antiganglioside antibodies.

Methods The clinical and serological data of 177 patients with GBS were retrospectively collected in Japan to assess the associations between a poor outcome and serum IgG antibodies against each ganglioside (GM1, GD1a, GalNAc-GD1a, GQ1b and GT1a). In addition, we investigated whether the combination of mEGOS and serum IgG antibodies against gangliosides is useful in predicting a poor outcome.

Results The patients with IgG anti-GD1a antibodies more frequently showed poor outcomes than those without these antibodies (9 (36%) of 25 vs 8 (6%) of 127 patients, p<0.001). Particularly, 80% showed a poor outcome when they had both serum IgG anti-GD1a antibody and a high mEGOS of ≥10 on day 7 of admission.

Conclusions The combination of serum IgG anti-GD1a antibodies and a high mEGOS could help in making a more accurate prognosis of patients than mEGOS alone, especially for predicting poor outcomes.

  • Guillain-Barre syndrome
  • ganglioside
  • neuropathy

https://doi.org/10.1136/jnnp-2020-323960

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    Footnotes

    • Contributors YY helped in the study concept and design, patient inclusion, acquisition of the data, analysis and interpretation of the data, drafted and revised the manuscript for intellectual content. MK, HS and SKus helped in study concept and design, patient inclusion, acquisition of the data, interpretation of data and revised the manuscript for intellectual content. MS, SKuw,TY, KN, AC, RK, TK, KK, TM, RY, HT, MM, KN and GS helped in patient inclusion, acquisition of the data, interpretation of data, revised the manuscript for intellectual content.

    • Funding This work was supported by the Practical Research Project for Rare/Intractable Diseases from the Japan Agency for Medical Research and Development (AMED, 16ek0109056h0003), Japan Society for the Promotion of Science (Grants-in-Aid for Scientific Research, 18H02745) and the Ministry of Health, Labour and Welfare of Japan (Health and Labour Sciences Research Grant on Rare and Intractable Diseases (Validation of Evidence-based Diagnosis and Guidelines, and Impact on QOL in Patients with Neuroimmunological Diseases)).

    • Competing interests YY, HS, MS, KN, RK, TK, KK, TM, RY, MM, KN, GS report no disclosures. MK reports personal fees from Teijin, CSL Behring, Japan Blood Products Organization, Nihon and Takeda Pharmaceutical, outside the submitted work. SKuw reports personal fees from Teijin and CSL Behring, outside the submitted work. He serves as Associate Editor of Journal of Neurology, Neurosurgery, and Psychiatry, and Editorial Board member of Journal of the Neurological Sciences. TY reports other from Teijin during the conduct of the study and other from Teijin outside the submitted work. AC reports other from Teijin outside the submitted work. HT reports grants and other from Eisai, Mitsubishi Tanabe pharma, Sumitomo Dainippon, Teijin, Takeda Pharmaceutical, Daiichi-Sankyo, Otsuka, Astellas, JB and Kyowa Kirin outside the submitted work. He reports other from Pfizer, Ono and Fujimoto Pharmaceutical, AbbVie, Bristol Myers Squibb, Sanofi, Asahi Kasei Medical, Biogen outside the submitted work. SKus reports grants from Japan Agency for Medical Research and Development (AMED), Japan Society for the Promotion of Science, and Ministry of Health, Labour and Welfare of Japan, during the conduct of the study. He reports grants from Teijin, Japan Blood Products Organization, Nihon Pharmaceutical, personal fees from Teijin, Japan Blood Products Organization, Nihon Pharmaceutical and CSL Behring, outside the submitted work.

    • Patient consent for publication Not required.

    • Ethics approval The Institutional Review Boards of Kindai university(ID:26-157) approved this study. Informed consent was obtained from all patients.

    • Provenance and peer review Not commissioned; externally peer reviewed.