gq1b-ganglioside and Respiratory-Insufficiency

Compared with 87 unventilated patients with Guillain-Barré syndrome (GBS), 44 ventilated patients with GBS more frequently had multiple cranial nerve involvement (91 vs 50%; p < 0.001) and IgG anti-GQ1b antibody (27 vs 8%; p = 0.006). In GBS patients without ophthalmoparesis, the presence of IgG anti-GQ1b antibody was associated with respiratory failure (12 [3/25] vs 0% [0/67]; p = 0.04). The presence of the antibody may be a factor predictive of respiratory failure in GBS.

Topics: Adult; Antibodies, Anti-Idiotypic; Disease Progression; Female; Gangliosides; Guillain-Barre Syndrome; Humans; Immunoglobulin G; Male; Middle Aged; Respiration, Artificial; Respiratory Insufficiency

Topics: Antibody Specificity; Autoantibodies; Autoantigens; Bulbar Palsy, Progressive; Cross Reactions; Gangliosides; Guillain-Barre Syndrome; Humans; Immunoglobulin G; Logistic Models; Ophthalmoplegia; Predictive Value of Tests; Respiration, Artificial; Respiratory Insufficiency

A patient with Bickerstaff's brain stem encephalitis (BBE) associated with anti-GQ1b antibody developed coma, severe weakness, and respiratory distress. The patient required ventilatory support. After having failed to improve on steroids, she was treated with plasmapheresis. She improved concomitantly with the plasmapheresis treatment and made a complete recovery. BBE associated with anti-GQ1b antibody is generally considered to be benign, and specific treatments have not been established. The results with this patient suggest that the condition is not always benign, and plasmapheresis may be beneficial in this disorder.

Topics: Adult; Antibodies; Brain Stem; Coma; Electroencephalography; Encephalitis; Evoked Potentials, Somatosensory; Female; Gangliosides; Glucocorticoids; Humans; Immunoglobulin M; Infusions, Intravenous; Methylprednisolone; Muscle Weakness; Nerve Growth Factors; Plasmapheresis; Respiration, Artificial; Respiratory Insufficiency