The Relationship Between Severe Guillain-Barré Syndrome and Ganglioside Antibody Spectrum in Children
Objective To explore the correlation between clinical characteristics and anti ganglioside antibodies(AGAs)in children with severe Guillain-Barré syndrome(GBS),and to evaluate the relationship between agas and disease classification and clinical features based on the analysis results,providing reference for rational clinical treatment and estimating disease prognosis.Methods During the observation period from January 2016 to June 2022,the medical records of children with this disease admitted to Qilu Hospital of Shandong University were reviewed.Based on the condition and electromyographic examination results,acute inflammatory demyelinating polyneuropathy(AIDP),acute motor axonal neuropathy(AMAN),and acute motor sensory axonal neuropathy(AMSAN)three subtypes were divided and serum gangliosides were detected in the children.Lipid antibodies,statistical analysis of the overall positive detection rate of antibodies,the composition ratio of antibodies in various subtypes of severe GBS patients,and comparison of clinical manifestations,laboratory indicators,disease treatment effects,etc.between the positive and negative antibody groups of each subtype.Results The overall positive detection rates of AGAs in the AIDP group,AMAN group,and AMSAN group were compared,and there was no statistically significant difference(P＞0.05).Gender and age were not independent influencing factors.The positive detection values of GM1 IgG,GQ1b IgG,and GD1a IgG in the AMAN group were higher than those in the AIDP group(P＜0.05).The incidence of limb weakness,bulbar symptoms(respiratory involvement),limb numbness,and disappearance of tendon reflexes in AIDP positive patients is higher than that in the antibody negative group.The degree of lower limb muscle weakness at admission is greater than that in the AIDP positive group;The increase in cerebrospinal fluid protein is more significant,the time required for muscle strength improvement is longer,and the lower limb muscle strength is lower at discharge(P＜0.05).Antibody positive group The ΔHughes score was(1.04±0.80)points,while the antibody negative group was(1.69±0.48)points,and the difference met statistical standards(P＜0.05).The incidence of seventh cranial nerve involvement was relatively higher in the AMAN group with positive AGAs compared to those with negative AGAs,and the difference met statistical standards(P＜0.05).Conclusion The positive detection rate of antibodies against GM1 IgG,GQ1b IgG,and GD1a IgG is higher in the AMAN group.AIDP children with AGAs positive for this disease have a relatively severe condition,poorer prognosis,and AMAN children have a higher risk of seventh cranial nerve involvement.
severe Guillain-Barré syndrome in childrenflaccid paralysisgangliosideganglioside antibodiescinical characteristicsprognosis
万方数据
维普
