K. Ohtsuka et al., FISHER-SYNDROME ASSOCIATED WITH IGG ANTI-GQ(1B) ANTIBODY FOLLOWING INFECTION BY A SPECIFIC SEROTYPE OF CAMPYLOBACTER-JEJUNI, Ophthalmology (Rochester, Minn.), 105(7), 1998, pp. 1281-1285
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.