ANTI-SULFATIDE ANTIBODIES IN PERIPHERAL NEUROPATHY

A study was carried out on 135 patients with chronic idiopathic neurop athy (63), neuropathy associated with monoclonal gammopathy (51, inclu ding eight with anti-MAG antibody activity) and the Guillain-Barre syn drome (GBS) (21). Serum IgM, IgG and IgA anti-sulphatide antibody titr es were compared with titres in 304 patients with other neurological o r immunological diseases and in 50 normal subjects. Titres were presen ted a) as the highest serum dilution at which reactivity could be dete cted, and b) in the linear region of the optical density curve. A subs tantial number of patients with neurological or immunological diseases had higher titres than normal subjects. Compared with normal and dise ase controls, five patients with neuropathy associated with IgMk monoc lonal gammopathy had raised titres of IgM anti-sulphatide antibodies a nd one patient with GBS had raised IgM, IgG and IgA anti-sulphatide an tibodies in the acute phase of the disease. Two patients had a predomi nantly axonal sensory neuropathy with presenting symptoms of painful p aresthesiae and minimal neurological deficit. Three patients had a pre dominantly demyelinating sensorimotor neuropathy associated with anti- MAG antibody activity. The patient with GBS had extensive sensory loss and antibody titres returned to normal within three weeks. Raised tit res of anti-sulphatide antibodies occurred in several types of neuropa thy, but all had some degree of sensory impairment and associated immu nological abnormality.