Ganglioside mimicry in the lipopolysaccharide (LPS) fraction of Campylobacter jejuni isolated from GuillainBarré syndrome (GBS) and Miller Fisher syndrome (MFS) patients was compared with isolates from patients with an uncomplicated enteritis. The antibody response to C. jejuni LPS and gangliosides in neuropathy patients and controls was compared as well. LPS from GBS and MFS-associated isolates more frequently contained ganglioside-like epitopes compared to control isolates. Almost all neuropathy patients showed a strong antibody response against LPS and multiple gangliosides in contrast to enteritis patients. Isolates from GBS patients more frequently had a GM1-like epitope than isolates from MFS patients. GQ1b-like epitopes were present in all MFS-associated isolates and was associated with anti-GQ1b antibody reactivity and the presence of oculomotor symptoms. These results demonstrate that the expression of ganglioside mimics is a risk factor for the development of post-Campylobacter neuropathy. This study provides additional evidence for the hypothesis that the LPS fraction determines the antiganglioside specificity and clinical features in postCampylobacter neuropathy patients.

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The clinical features and symptoms of postpartum psychoses are presented in relation to the classification according to the Research Diagnostic Criteria (RDC) and the concept of "puerperal psychosis". A number of symptoms, ie confusional symptoms, depersonalization, misrecognitions and the "kaleidoscopic" picture are shown to be prominent features. In schizoaffective disorder and unspecified functional psychosis a higher frequency of confusional symptoms, misrecognitions, thematic delusions and a "kaleidoscopic" course of illness was found compared to schizophrenia, mania or depression. The findings of this study support a special status for postpartum psychosis and suggest a link with the concept of cycloid psychosis. In the management of postpartum mental disorder the risk of child-directed aggression, suicide and sudden relapses into psychosis requires special attention.

The regimen for IVIg maintenance treatment varies considerably between patients with chronic immune-mediated neuropathies. Although it is widely recognized that treatment regimens should be improved, detailed pharmacokinetics (PK) of IVIg have not yet been established. We aimed to determine the PK of IVIg maintenance treatment in patients with clinically stable, treatment-dependent, chronic immune-mediated neuropathy. Patients received a median IVIg dose of 30 g (range, 15-70 g) every 14 days (range, 7-28 days) resulting in high IgG peak levels (median, 25.9 g/L; range, 16.7-41.0 g/L) and trough levels (median, 16.1 g/L; range, 9.7-23.6 g/L). IgG PK parameters, including half-life (median, 23.1 days; range, 11-60 days), were constant during subsequent courses in the same patients, but varied considerably between patients. The IgG levels at 1 week after infusion correlated with grip strength. These results provide insight into the PK of IVIg maintenance treatment in patients with chronic immune-mediated neuropathies.