Serum and cerebrospinal fluid immune complexes containing hepatitis B surface antigen in Guillain-Barré syndrome.

A 76-yr-old male presented with Guillain-Barré syndrome after acute hepatitis B virus infection. Main immunologic features were: (a) high levels of circulating hepatitis B surface antigen-containing immune complexes in serum and cerebrospinal fluid during the acute neurologic syndrome, and (b) clearance of immune-complex material with recovery. Our data indicate that these immune complexes in cerebrospinal fluid reflect leakage from the systemic circulation via a deranged blood-brain barrier and are not generated in the cerebrospinal compartment. Possibly deposition of such immune complexes along nerve structures is important in the immunopathogenesis of some cases of Guillain-Barré syndrome.