Guillain-Barré syndrome with a sensory level and positive anti-GM4-IgM antibody
Guillain-Barré syndrome(GBS)is an immune-mediated acute inflammatory peripheral neuropathy.It primarily manifests as acute,symmetrical,flaccid paralysis of multiple nerve roots and peripheral neuropathy,with or without cranial nerve involvement.The two most common subtypes of GBS are acute inflammatory demyelinating polyneu-ropathy(AIDP)and acute motor axonal neuropathy(AMAN).Other less common types include acute motor sensory axo-nal neuropathy(AMSAN)and Miller-Fisher syndrome(MFS).In addition,other variants,such as pharyngeal-cervical-brachial variant,multiple cranial neuropathy,and paraplegia,have been increasingly reported.Therefore,GBS is gradu-ally being recognized as a spectrum of diseases.Previous studies have found and confirmed that ganglioside antibodies are associated with GBS,including anti-GM1,anti-GM2,anti-GM3,anti-GM4,anti-GD1a,anti-GD1b,anti-GT1a,anti-GT1b,and anti-GQ1b antibodies.However,GBS with a sensory level has been rarely reported.This report presents a case of anti-GM4 IgM-positive GBS with a sensory level following gastrointestinal surgery,which has not been previously reported.The findings of this study may help enhance awareness of this disease and reduce misdiagnosis.