Abstract
Objective We examined the clinical and serologic features of Guillain-Barré syndrome (GBS)-related diseases (GBSRDs), including GBS, Fisher syndrome (FS), and Bickerstaff brainstem encephalitis (BBE), after influenza virus infection (GBSRD-I) to reveal potential underlying autoimmune mechanisms.
Methods We retrospectively investigated the presence of antiglycolipid antibodies against 11 glycolipids and the clinical features of 63 patients with GBSRD-I. Autoantibody profiles and clinical features were compared with those of 82 patients with GBSRDs after Campylobacter jejuni infection (GBSRD-C).
Results The anti-GQ1b seropositivity rate was significantly higher, whereas the GM1 and GD1a seropositivity rates were significantly lower in GBSRD-I compared with GBSRD-C. Anti-GQ1b and anti-GT1a were the most frequently detected antiglycolipid antibodies in GBSRD-I (both 15/63, 24%). Consequently, FS was more frequent in GBSRD-I than GBSRD-C (22% vs 9%, p < 0.05). In addition, as for GBS, cranial nerve deficits, sensory disturbances, and ataxia were more frequent in the cases after influenza infection (GBS-I) than in those after C. jejuni infection (GBS-C) (46% vs 15%, 75% vs 46%, and 29% vs 4%, respectively; all p < 0.01). Nerve conduction studies revealed acute inflammatory demyelinating polyneuropathy (AIDP) in 60% of patients with GBS-I but only 25% of patients with GBS-C (p < 0.01).
Conclusions Anti-GQ1b antibodies are the most frequently detected antibodies in GBSRD-I. Compared with GBS-C, GBS-I is characterized by AIDP predominance and frequent presence of cranial nerve involvement and ataxia.
Glossary
- AIDP=
- acute inflammatory demyelinating polyneuropathy;
- AMAN=
- acute motor axonal neuropathy;
- BBE=
- Bickerstaff brainstem encephalitis;
- FS=
- Fisher syndrome;
- GBS=
- Guillain-Barré syndrome;
- GBS-C=
- Guillain-Barré syndrome after C. jejuni infection;
- GBS-I=
- Guillain-Barré syndrome after influenza virus infection;
- GBSRD=
- Guillain-Barré syndrome–related disease;
- GBSRD-C=
- Guillain-Barré syndrome–related disease after C jejuni infection;
- GBSRD-I=
- Guillain-Barré syndrome–related disease after influenza virus infection;
- HA=
- hemagglutinin;
- NA=
- neuraminidase;
- NCS=
- nerve conduction study;
- RIDT=
- rapid influenza diagnostic test
Footnotes
Go to Neurology.org/NN for full disclosures. Funding information is provided at the end of the article.
The Article Processing Charge was funded by the authors.
- Received January 4, 2019.
- Accepted in final form April 5, 2019.
- Copyright © 2019 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology.
This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License 4.0 (CC BY-NC-ND), which permits downloading and sharing the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
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