Serum IgG anti-GD1a antibody and mEGOS predict outcome in Guillain-Barré syndrome.

Approximately 15%-20% of patients with Guillain-Barré syndrome (GBS) are unable to walk independently at 6 months from the onset of neurological symptom. The modified Erasmus GBS outcome score (mEGOS) has been reported as a prognostic tool.Herein we investigated the association between a poor outcome, inability to walk independently at 6 months and presence of antiganglioside antibodies. The clinical and serological data of 177 patients with GBS were retrospectively collected in Japan to assess the associations between a poor outcome and serum IgG antibodies against each ganglioside (GM1, GD1a, GalNAc-GD1a, GQ1b and GT1a). In addition, we investigated whether the combination of mEGOS and serum IgG antibodies against gangliosides is useful in predicting a poor outcome. The patients with IgG anti-GD1a antibodies more frequently showed poor outcomes than those without these antibodies (9 (36%) of 25 vs 8 (6%) of 127 patients, p<0.001). Particularly, 80% showed a poor outcome when they had both serum IgG anti-GD1a antibody and a high mEGOS of ≥10 on day 7 of admission. The combination of serum IgG anti-GD1a antibodies and a high mEGOS could help in making a more accurate prognosis of patients than mEGOS alone, especially for predicting poor outcomes.

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Competing interests: YY, HS, MS, KN, RK, TK, KK, TM, RY, MM, KN, GS report no disclosures. MK reports personal fees from Teijin, CSL Behring, Japan Blood Products Organization, Nihon and Takeda Pharmaceutical, outside the submitted work. SKuw reports personal fees from Teijin and CSL Behring, outside the submitted work. He serves as Associate Editor of Journal of Neurology, Neurosurgery, and Psychiatry, and Editorial Board member of Journal of the Neurological Sciences. TY reports other from Teijin during the conduct of the study and other from Teijin outside the submitted work. AC reports other from Teijin outside the submitted work. HT reports grants and other from Eisai, Mitsubishi Tanabe pharma, Sumitomo Dainippon, Teijin, Takeda Pharmaceutical, Daiichi-Sankyo, Otsuka, Astellas, JB and Kyowa Kirin outside the submitted work. He reports other from Pfizer, Ono and Fujimoto Pharmaceutical, AbbVie, Bristol Myers Squibb, Sanofi, Asahi Kasei Medical, Biogen outside the submitted work. SKus reports grants from Japan Agency for Medical Research and Development (AMED), Japan Society for the Promotion of Science, and Ministry of Health, Labour and Welfare of Japan, during the conduct of the study. He reports grants from Teijin, Japan Blood Products Organization, Nihon Pharmaceutical, personal fees from Teijin, Japan Blood Products Organization, Nihon Pharmaceutical and CSL Behring, outside the submitted work.