CAMPYLOBACTER-JEJUNI INFECTIONS AND ANTI-GM1 ANTIBODIES IN GUILLAIN-BARRE-SYNDROME

The group of patients with Guillain-Barri syndrome (GBS) is very heter ogenous with regard to antecedent infections, immunological parameters , clinical manifestations, and response to treatment. In this study, t he presumed pathogenic factors anti-GM1 antibodies and Campylobacter j ejuni infections were related to the clinical characteristics. Serum f rom 154 patients with GBS, 63 patients with other neurological disease s (OND), and 50 normal controls (NC) were tested for the presence of a ntibodies against GM1 and C. jejuni. Anti-GM1 antibodies were detected in 31 (20%) GBS patients, 5 (8%) OND patients, and in none of the NC. Evidence for a recent C. jejuni infection was found in 49 (32%) GBS p atients and less often in OND patients (11%) or NC (8%). In GBS patien ts, the presence of anti-GM1 antibodies was significantly associated w ith C. jejuni infections. The subgroup of GBS patients with anti-GM1 a ntibodies suffered more often from a rapidly progressive and more seve re neuropathy with predominantly distal distribution of weakness, with out deficits of cranial nerves or sensory disturbances. The subgroup w ith C. jejuni infection also more often had a severe pure motor varian t of GBS. Recovery of the patients with anti-GM1 antibodies and C. jej uni infections was not as good after plasma exchange compared with int ravenous immunoglobulins.