重新探讨与 IgG 抗 GM1 抗体相关的下运动神经元综合征。

Lower motor neuron syndrome associated with IgG anti-GM1 antibodies revisited.

机构信息

Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore; Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.

Department of Neurology, Dokkyo Medical University, Tochigi, Japan.

出版信息

J Neuroimmunol. 2014 Jul 15;272(1-2):62-6. doi: 10.1016/j.jneuroim.2014.04.014. Epub 2014 May 2.

DOI:10.1016/j.jneuroim.2014.04.014

PMID:24841627

Abstract

A patient, who developed an amyotrophic lateral sclerosis-like disorder subsequent to ganglioside treatment, had IgM antibodies to GM2 as well as to minor gangliosides X1 and X2 containing GM2 epitope. These gangliosides as well as GM1 were tested in 655 sera obtained from patients who were suspected of having amyotrophic lateral sclerosis or motor neuron disease to find a treatable condition. Three patients had high titers of IgG anti-GM1 antibodies, but no IgM anti-GM1 antibodies. One of the patients also had IgG anti-X2 antibodies. The patients, being diagnosed with having lower motor neuron syndrome, had neither upper motor neuron signs nor multifocal conduction block. Both IgM and IgG anti-GM1 antibodies should be tested in patients who have lower motor neuron syndrome.

摘要

一位患者在接受神经节苷脂治疗后出现类似于肌萎缩侧索硬化症的疾病，其 IgM 抗体针对 GM2 以及含有 GM2 表位的小神经节苷脂 X1 和 X2。为了寻找可治疗的疾病，在怀疑患有肌萎缩侧索硬化症或运动神经元疾病的 655 例患者的血清中检测了这些神经节苷脂和 GM1。有 3 例患者 IgG 抗 GM1 抗体滴度较高，但无 IgM 抗 GM1 抗体。其中一名患者还 IgG 抗 X2 抗体。这些被诊断为下运动神经元综合征的患者既没有上运动神经元体征也没有多灶性传导阻滞。对于有下运动神经元综合征的患者，应该同时检测 IgM 和 IgG 抗 GM1 抗体。