PDF(Pubmed)
Abstract：
BACKGROUND: Guillain-Barré syndrome (GBS), as the most common cause of acute flaccid paralysis worldwide, is considered a part of a clinical spectrum in which discrete, complete, or incomplete forms of GBS and overlapping syndromes lie on the basis of their clinical features. The term overlapping Miller Fisher syndrome (MFS)/GBS is used when patients with MFS also suffer from progressive motor weakness of the limbs. Anti-ganglioside GQ1b has been specifically associated with MFS and ophthalmoplegia.
METHODS: Here, we report a Chinese girl who was diagnosed with overlapping MFS/GBS showing acute flaccid paralysis of all four limbs, sensory symptoms, cranial nerve dysfunction, autonomic involvement, ophthalmoplegia, and ataxia. She had high serum and cerebrospinal fluid titres of monospecific anti-GM4 IgG antibody instead of anti-GQ1b antibody in the acute phase.
CONCLUSIONS: Anti-GM4 antibodies usually coexist with other antiganglioside antibodies, leading to missed diagnoses. The findings of the present study show that antibodies to ganglioside GM4 may in overlapping MFS/GBS as the lone immunological factors.
METHODS: Here, we report a Chinese girl who was diagnosed with overlapping MFS/GBS showing acute flaccid paralysis of all four limbs, sensory symptoms, cranial nerve dysfunction, autonomic involvement, ophthalmoplegia, and ataxia. She had high serum and cerebrospinal fluid titres of monospecific anti-GM4 IgG antibody instead of anti-GQ1b antibody in the acute phase.
CONCLUSIONS: Anti-GM4 antibodies usually coexist with other antiganglioside antibodies, leading to missed diagnoses. The findings of the present study show that antibodies to ganglioside GM4 may in overlapping MFS/GBS as the lone immunological factors.
摘要：
背景：格林-巴利综合征（GBS），作为全球急性弛缓性麻痹的最常见原因，被认为是临床频谱的一部分，完成,或不完全形式的GBS和重叠综合征取决于其临床特征。当患有MFS的患者也患有四肢进行性运动无力时，使用术语重叠的MillerFisher综合征（MFS）/GBS。抗神经节苷脂GQ1b与MFS和眼肌麻痹特异性相关。
方法：这里，我们报道了一名中国女孩，她被诊断为重叠的MFS/GBS，显示所有四肢的急性弛缓性麻痹，感觉症状,颅神经功能障碍,自主神经参与，眼肌麻痹,和共济失调.在急性期，她的单特异性抗GM4IgG抗体而不是抗GQ1b抗体的血清和脑脊液滴度很高。
结论：抗GM4抗体通常与其他抗神经节苷脂抗体共存，导致漏诊。本研究的结果表明，神经节苷脂GM4抗体可能在重叠的MFS/GBS中作为唯一的免疫因子。
方法：这里，我们报道了一名中国女孩，她被诊断为重叠的MFS/GBS，显示所有四肢的急性弛缓性麻痹，感觉症状,颅神经功能障碍,自主神经参与，眼肌麻痹,和共济失调.在急性期，她的单特异性抗GM4IgG抗体而不是抗GQ1b抗体的血清和脑脊液滴度很高。
结论：抗GM4抗体通常与其他抗神经节苷脂抗体共存，导致漏诊。本研究的结果表明，神经节苷脂GM4抗体可能在重叠的MFS/GBS中作为唯一的免疫因子。
