Evaluating the Status of Antiganglioside Antibodies in Children with Guillain-Barré Syndrome

Hashemilar, Mazyar; Barzegar, Mohammad; Nikanfar, Masoud; Bonyadi, Mohammad Reza; Goldust, Mohamad; Ramouz, Ali; Ebrahimi, Faeghe

doi:10.1159/000355830

Cited by 5 publications

(6 citation statements)

References 60 publications

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“…The test accuracy varies depending on GBS subtype, tested antigen and control group. Anti‐GM1 IgG antibody sensitivity for the whole group of GBS patients ranges from 20% to 69% and varies between geographical regions 71–75,101 . Anti‐GM1 specificity is reported to be high (94%–98%) in GBS compared with healthy controls and other neurological diseases 25,54,73,102 .…”

Section: Resultsmentioning

confidence: 99%

“…Evidence summary: Serum antibodies that have been tested in GBS cases include GM1, [71][72][73][74][75] GM1b, 76 GD1a, 77 GQ1b, [78][79][80][81][82][83] GalNAc-GD1a, [84][85][86] GT1a, 87 GD1b, GD3, O-GD3, GT3, O-GT3, 88 sulfatide, 89,90 galactocerebroside, 91,92 CNTN1, 93 NF155 and NF 186, 94,95 cardiolipin, 96 LM1, [97][98][99] sulphated glycolipids, 89 P0 and PMP22. 100 The test accuracy varies depending on GBS subtype, tested antigen and control group.…”

Section: Considerations Supporting the Gpps (Supporting Information)mentioning

confidence: 99%

See 1 more Smart Citation

European Academy of Neurology/Peripheral Nerve Society Guideline on diagnosis and treatment of Guillain–Barré syndrome

van Doorn,

Van den Bergh,

Hadden

et al. 2023

Euro J of Neurology

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Guillain–Barré syndrome (GBS) is an acute polyradiculoneuropathy. Symptoms may vary greatly in presentation and severity. Besides weakness and sensory disturbances, patients may have cranial nerve involvement, respiratory insufficiency, autonomic dysfunction and pain. To develop an evidence‐based guideline for the diagnosis and treatment of GBS, using Grading of Recommendations, Assessment, Development and Evaluation (GRADE) methodology a Task Force (TF) of the European Academy of Neurology (EAN) and the Peripheral Nerve Society (PNS) constructed 14 Population/Intervention/Comparison/Outcome questions (PICOs) covering diagnosis, treatment and prognosis of GBS, which guided the literature search. Data were extracted and summarised in GRADE Summaries of Findings (for treatment PICOs) or Evidence Tables (for diagnostic and prognostic PICOs). Statements were prepared according to GRADE Evidence‐to‐Decision (EtD) frameworks. For the six intervention PICOs, evidence‐based recommendations are made. For other PICOs, good practice points (GPPs) are formulated. For diagnosis, the principal GPPs are: GBS is more likely if there is a history of recent diarrhoea or respiratory infection; CSF examination is valuable, particularly when the diagnosis is less certain; electrodiagnostic testing is advised to support the diagnosis; testing for anti‐ganglioside antibodies is of limited clinical value in most patients with typical motor‐sensory GBS, but anti‐GQ1b antibody testing should be considered when Miller Fisher syndrome (MFS) is suspected; nodal–paranodal antibodies should be tested when autoimmune nodopathy is suspected; MRI or ultrasound imaging should be considered in atypical cases; and changing the diagnosis to acute‐onset chronic inflammatory demyelinating polyradiculoneuropathy (A‐CIDP) should be considered if progression continues after 8 weeks from onset, which occurs in around 5% of patients initially diagnosed with GBS. For treatment, the TF recommends intravenous immunoglobulin (IVIg) 0.4 g/kg for 5 days, in patients within 2 weeks (GPP also within 2–4 weeks) after onset of weakness if unable to walk unaided, or a course of plasma exchange (PE) 12–15 L in four to five exchanges over 1–2 weeks, in patients within 4 weeks after onset of weakness if unable to walk unaided. The TF recommends against a second IVIg course in GBS patients with a poor prognosis; recommends against using oral corticosteroids, and weakly recommends against using IV corticosteroids; does not recommend PE followed immediately by IVIg; weakly recommends gabapentinoids, tricyclic antidepressants or carbamazepine for treatment of pain; does not recommend a specific treatment for fatigue. To estimate the prognosis of individual patients, the TF advises using the modified Erasmus GBS outcome score (mEGOS) to assess outcome, and the modified Erasmus GBS Respiratory Insufficiency Score (mEGRIS) to assess the risk of requiring artificial ventilation. Based on the PICOs, available literature and additional discussions, we provide flow charts to assist making clinical decisions on diagnosis, treatment and the need for intensive care unit admission.

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Section: Resultsmentioning

confidence: 99%

Section: Considerations Supporting the Gpps (Supporting Information)mentioning

confidence: 99%

European Academy of Neurology/Peripheral Nerve Society Guideline on diagnosis and treatment of Guillain–Barré syndrome

van Doorn,

Van den Bergh,

Hadden

et al. 2023

Euro J of Neurology

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“…Hashemilar et al. (2014) suggested that EUROLINE method could be used instead of the ELISA method except for the anti‐GQ1b antibody.…”

Section: Discussionmentioning

confidence: 99%

Association of anti‐gangliosides antibodies and anti‐CMV antibodies in Guillain–Barré syndrome

et al. 2017

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IntroductionNumerous types of infection were closely related to GBS, mainly including Campylobacter jejuni, Cytomegalovirus, which may lead to the production of anti‐gangliosides antibodies (AGA). Currently, although there are increased studies on the AGA and a few studies of anti‐CMV antibodies in GBS, the association between them remains poorly documented. Therefore, our research aims to analyze the correlation of anti‐CMV antibodies and AGA in GBS.MethodsA total of 29 patients with GBS were enrolled in this study. The CMV antibodies were tested by the electrochemiluminescence immunoassay “ECLIA” (Roche Diagnostics GmbH). The serum gangliosides were determined by The EUROLINE test kit.ResultsOf the 29 patients with GBS, 9 (31%) were AGA‐seropositive, in which 22 were CMV‐IgG positive in CSF at the same time, but all 29 samples were CMV‐IgM negative in both serum and CSF. In the AGA‐positive group, the rate of both serum and CSF positive was 87.5% (7/8), higher than 50% (7/14) of the negative group, although no statistical significance was found. In addition, we found that there was a trend of higher ratio of men, a younger age onset, less frequent preceding infection, a higher level of CSF proteins, and less frequent cranial nerve deficits, although the data did not reach a statistical significance.ConclusionIn spite of no statistical significance association was found between serum AGA and CMV‐IgG in serum and CSF. However, we found that there was a trend of high positive rate of both serum and CSF‐CMV‐IgG in AGA‐positive than the negative group. So we should further expand the sample size to analyze the association between AGA and CMV or other neurotropic virus antibodies in various diseases, to observe whether they could be serological marker of these diseases (especially GBS) or the underlying pathogenesis.

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Section: Considerations Supporting the Gpps (Supporting Information)mentioning

confidence: 99%

European Academy of Neurology/Peripheral Nerve Society Guideline on diagnosis and treatment of Guillain–Barré syndrome

van Doorn,

Van den Bergh,

Hadden

et al. 2023

J Peripheral Nervous Sys

View full text Add to dashboard Cite

Guillain–Barré syndrome (GBS) is an acute polyradiculoneuropathy. Symptoms may vary greatly in presentation and severity. Besides weakness and sensory disturbances, patients may have cranial nerve involvement, respiratory insufficiency, autonomic dysfunction and pain. To develop an evidence‐based guideline for the diagnosis and treatment of GBS, using Grading of Recommendations, Assessment, Development and Evaluation (GRADE) methodology, a Task Force (TF) of the European Academy of Neurology (EAN) and the Peripheral Nerve Society (PNS) constructed 14 Population/Intervention/Comparison/Outcome questions (PICOs) covering diagnosis, treatment and prognosis of GBS, which guided the literature search. Data were extracted and summarised in GRADE Summaries of Findings (for treatment PICOs) or Evidence Tables (for diagnostic and prognostic PICOs). Statements were prepared according to GRADE Evidence‐to‐Decision (EtD) frameworks. For the six intervention PICOs, evidence‐based recommendations are made. For other PICOs, good practice points (GPPs) are formulated. For diagnosis, the principal GPPs are: GBS is more likely if there is a history of recent diarrhoea or respiratory infection; CSF examination is valuable, particularly when the diagnosis is less certain; electrodiagnostic testing is advised to support the diagnosis; testing for anti‐ganglioside antibodies is of limited clinical value in most patients with typical motor‐sensory GBS, but anti‐GQ1b antibody testing should be considered when Miller Fisher syndrome (MFS) is suspected; nodal–paranodal antibodies should be tested when autoimmune nodopathy is suspected; MRI or ultrasound imaging should be considered in atypical cases; and changing the diagnosis to acute‐onset chronic inflammatory demyelinating polyradiculoneuropathy (A‐CIDP) should be considered if progression continues after 8 weeks from onset, which occurs in around 5% of patients initially diagnosed with GBS. For treatment, the TF recommends intravenous immunoglobulin (IVIg) 0.4 g/kg for 5 days, in patients within 2 weeks (GPP also within 2–4 weeks) after onset of weakness if unable to walk unaided, or a course of plasma exchange (PE) 12–15 L in four to five exchanges over 1–2 weeks, in patients within 4 weeks after onset of weakness if unable to walk unaided. The TF recommends against a second IVIg course in GBS patients with a poor prognosis; recommends against using oral corticosteroids, and weakly recommends against using IV corticosteroids; does not recommend PE followed immediately by IVIg; weakly recommends gabapentinoids, tricyclic antidepressants or carbamazepine for treatment of pain; does not recommend a specific treatment for fatigue. To estimate the prognosis of individual patients, the TF advises using the modified Erasmus GBS outcome score (mEGOS) to assess outcome, and the modified Erasmus GBS Respiratory Insufficiency Score (mEGRIS) to assess the risk of requiring artificial ventilation. Based on the PICOs, available literature and additional discussions, we provide flow charts to assist making clinical decisions on diagnosis, treatment and the need for intensive care unit admission.

show abstract

Evaluating the Status of Antiganglioside Antibodies in Children with Guillain-Barré Syndrome

Cited by 5 publications

References 60 publications

European Academy of Neurology/Peripheral Nerve Society Guideline on diagnosis and treatment of Guillain–Barré syndrome

European Academy of Neurology/Peripheral Nerve Society Guideline on diagnosis and treatment of Guillain–Barré syndrome

Association of anti‐gangliosides antibodies and anti‐CMV antibodies in Guillain–Barré syndrome

European Academy of Neurology/Peripheral Nerve Society Guideline on diagnosis and treatment of Guillain–Barré syndrome

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