Kimura F, Ito T, Yuki N, Nakajima H, Tanaka T, Shinoda K, Ohsawa N
First Department of Internal Medicine, Osaka Medical College, Takatsuki.
Intern Med. 1995 Oct;34(10):1009-14. doi: 10.2169/internalmedicine.34.1009.
We report two Guillain-Barré Syndrome (GBS) patients with culture-proven Campylobacter jejuni (Penner19/Lior 7). Elevated anti-C.jejuni IgA antibody declined to the normal range within one month, elevation of anti-C.jejuni IgM antibody lasted for 3 months and the titers of anti-C.jejuni IgG antibody were still elevated at one year after the neurologic onset. Serological criteria for antecedent C.jejuni infection in GBS patients should require 1) high titer of serum IgA and/or IgM antibody against C.jejuni followed by seroconversion of the IgA and/or IgM and 2) a 4-fold decline of IgG serum dilution against C.jejuni. Anti-C.jejuni antibodies in cerebrospinal fluid (CSF) reached the maximum value at one month after their neurologic onset which may not be responsible for the main pathological mechanism in the development of GBS. Anti-GM1 antibodies in serum and CSF were parallel with those of anti-C.jejuni antibodies during the course of the disease.
我们报告了两例经培养证实为空肠弯曲菌（Penner19/Lior 7型）感染的吉兰-巴雷综合征（GBS）患者。抗空肠弯曲菌IgA抗体升高在1个月内降至正常范围，抗空肠弯曲菌IgM抗体升高持续3个月，而抗空肠弯曲菌IgG抗体滴度在神经症状出现后1年仍处于升高状态。GBS患者既往空肠弯曲菌感染的血清学标准应具备：1）血清中针对空肠弯曲菌的IgA和/或IgM抗体滴度高，随后IgA和/或IgM发生血清学转换；2）抗空肠弯曲菌IgG血清稀释度下降4倍。脑脊液（CSF）中的抗空肠弯曲菌抗体在神经症状出现后1个月达到最大值，这可能并非GBS发病主要病理机制的原因。在疾病过程中，血清和脑脊液中的抗GM1抗体与抗空肠弯曲菌抗体平行。
