We earlier reported cases of 2 patients with severe acute Guillain-Bar
re syndrome (GBS) associated with high-IgG anti-GD1a antibody titer. W
e now have investigated the autoantibody against GD1a or GM, in 37 GBS
patients using the enzyme-linked immunosorbent assay and have found a
statistically significant association between IgG anti-GD1a antibody
and the severity of the disease (need of a respirator for more than 1
month and a poor functional prognosis 3 months after neurologic onset)
. An autopsy which showed severe GBS associated with IgG anti-GD1a ant
ibody produced the following findings: (1) severe axonal degeneration
and segmental demyelination of peripheral nerves; (2) lymphocytic infi
ltration; and (3) marked central chromatolysis of the lower motoneuron
s.