Analysis Of Serum Anti-ganglioside Antibody Subtypes And Clinical Characteristics In Patients With Peripheral Neuropathy

Objective To analyze serum anti-ganglioside antibody subtypes and clinical characteristics in patients with peripheral neuropathy,so as to help guide the clinical differential diagnosis and evaluate the prognosis.Methods The clinical data of 27 patients which were diagnosed peripheral neuropathy and serum anti-ganglioside antibodies were positive admitted to the General Hospital of Ningxia Medical University from April 2021 to January 2023 were collected.The anti-ganglioside antibody subtypes and clinical characteristics were analyzed,and the prognosis was explored.Results 1.Of the 27 patients included in this study,16 cases(59%)were classical Guillain-Barré syndrome(GBS),5 cases(18%)were Miller-Fisher syndrome(MFS),1 case(4%)was Chronic inflammatory demyelinating polyradiculoneuropathy(CIDP),1 case(4%)was alcohol-related peripheral neuropathy,and 4 cases(15%)were peripheral neuropathy of unknown origin.Prodromal events occurred in 14 cases(51.9%),including 5 cases with a history of respiratory infection,3 cases with a history of diarrhea,2 cases with a history of vaccination,1 case with a history of surgery,2 cases with a history of respiratory infection with fever,and 1 case with a history of respiratory infection with diarrhea;limb weakness in15 cases(55.6%);ataxia in 8 cases(29.6%);cranial nerve involvement in 10 cases(37.0%),external ophthalmoplegia in 4 cases,facial paralysis in 2 cases,bulbar paralysis in 3 cases,ophthalmoplegia accompanied by facial paralysis in 1 case.2.A total of 11 subtypes of anti-ganglioside antibodies were detected in 27 patients,and antibody subtypes included GM1(13 cases),GM2(3 cases),GM3(4 cases),GM4(3 cases),GD1a(3 cases),GD1b(5 cases),GD2(1 case),GD3(13 cases),GT1a(9 cases),GT1b(1case)and GQ1b(3 cases).The positive rates of anti-GM1 antibody(48.1%),anti-GD3antibody(48.1%),anti-GT1 a antibody(33.3%)and anti-GD1 b antibody(18.5%)were higher.3.GM1 antibody and GD1 b antibody were more common in classical GBS.GT1 a antibody was more common in classical GBS and MFS.Antibodies to GD1 a and GQ1 b were found only in classical GBS and MFS.GD3 antibody was found in classical GBS,MFS,CIDP,alcoholic peripheral neuropathy and peripheral neuropathy of unknown origin.4.There were 13 patients(48.1%)with positive GM1 antibody and 10 patients(76.9%)with limb weakness.There were 14 patients(51.9%)with negative GM1 antibody and 5patients(35.7%)with limb weakness.The incidence of limb weakness in patients with positive GM1 antibody was significantly higher than that in patients with negative GM1antibody(P<0.05).There were 9 patients(33.3%)with positive GT1 a antibody and 4 patients(44.4%)with ophthalmoplegia.There were 18 patients(66.7%)with negative GT1 a antibody,and 1 patient(5.6%)with ophthalmoplegia.The incidence of ophthalmoplegia in patients with positive GT1 a antibody was significantly higher than that in patients with negative GT1 a antibody(P<0.05).5.There were no significant differences in HFGS score,ODSS score and △HFGS between patients with GM1 antibody,GD3 antibody,GT1 a antibody and GD1 b antibody positive and negative patients(P>0.05).Conclusion1.Serum anti-ganglioside antibodies can be detected in various types of peripheral neuropathy,among which GBS has a higher positive rate,and GM1 antibody and GD1 b antibody are more common in classical GBS.GT1 a antibody is more common in classical GBS and MFS.2.Patients with GM1 antibody are more likely to have limb weakness,while patients with GT1 a antibody are more likely to have ophthalmoplegia.