Guillain-Barré syndrome associated with high titers of anti-GM1 antibodies

We found high titers of anti-GM1 antinodies (1/1280 or more) in 3 of 14 consecutive patients 921%) with Guillain-Barré syndrome (GBS) and in 2 additional patients who developed GBS, 10–11 days after starting parenteral treatment with gangliosides. Antibodies were IgG in 4 patients and IgM in on Although the clinical features in all the patients with high anti-GM1 titers fulfilled the criteria for the diagnosis of GBS and in 4 of them, proteins but not cells were elevated in cerebrospinal fluid, electtodiagnostic studies in 3 patients showed prominent signs of axonal degeneration, that in one case were confirmed by morphological studies in sural nerve biopsy. No recent antecedent infection was reported by these patients, but in 3, including patients treated with gangliosides, anti- Campylobacter jejuni antibodies were elevated. In 3 patients a consistent decrease in anti-GM1 levels was observed after the acute phase of the disease suggesting that the frequent occurence of these antibodies in patients with GBS and their frequent association with a prominent axonal impairment may have pathogenetic relevance.