FISHER-SYNDROME ASSOCIATED WITH IGG ANTI-GQ(1B) ANTIBODY FOLLOWING INFECTION BY A SPECIFIC SEROTYPE OF CAMPYLOBACTER-JEJUNI

Objective: The purpose of the study was to describe clinical and serol ogic features of Fisher syndrome associated with IgG anti-GQ(1b) gangl ioside antibody following Campylobacter jejuni enteritis. Design: A cl inical trial, Participants: Four consecutive patients with Fisher synd rome were studied. Intervention: Samples of sera from four patients we re tested for reactivity to GQ(1b) ganglioside by enzyme-linked immuno sorbent assay (ELISA). Campylobacter jejuni strains isolated from samp les of stool from three patients were serotyped by the method of Penne r and Hennessy and that of Lior. Main Outcome Measures: Serum IgG anti -GQ(1b) antibody titer and serotypes of C. jejuni. Results: Diplopia o ccurred 8 to 14 days after the onset of diarrhea. Campylobacter jejuni was isolated from samples of stool from all of the patients, ELISA re vealed a high serum IgG anti-GQ(1b) antibody titer for all four patien ts. Two patients had high serum titers of other antiganglioside antibo dies frequently related to Guillain-Barre syndrome, These two patients developed limb weakness following the onset of ophthalmoplegia. The C . jejuni serotype was Penner's serotype 2 for all three of the patient s tested, Conclusions: These findings suggest that C. jejuni, especial ly Penner's serotype 2, enteritis could trigger development of Fisher syndrome associated with IgG anti-GQ(1b) antibody.