THE CLINICAL CORRELATES OF HIGH-TITER IGG ANTI-GM1 ANTIBODIES

Serum IgG anti-GM1 antibodies have been reported to occur in a variety of disorders, including Guillain-Barre syndrome and chronic polyneuro pathies. Of over 5,000 serums tested in our laboratory, high titers of selective IgG anti-GM1 antibodies (>1:1,000) and without binding to s ulfatide Fc ere found in 35 patients. Clinical correlation revealed th at almost all patients had axonal, motor neuropathies. One subgroup wa s comprised of individuals with an acute motor neuropathy, described e ither as an acute axonal Guillain-Barre-like syndrome that was occasio nally associated with a prodrome of Campylobacter jejuni enteritis or as Chinese paralysis syndrome. A second group of patients had chronic asymmetric lower motor neuron (LMN) syndromes with no conduction block or other evidence of demyelination. The presence of selective high-ti ter IgG anti-GM1 antibody reactivity in serum is uncommon but when pre sent is strongly associated with acute axonal motor neuropathies or ch ronic asymmetric LMN syndromes.