Rinsho Shinkeigaku (Clinical Neurology)

Case Report

A case of Guillain-Barré syndrome complicated with severe autonomic failure and presented elevated anti-GD1b and anti-GQ1b antibody

Ken Inoue, M. D. , Ph. D. , Tatsuo Kohriyama, M. D. , Ph. D. , Junko Ikeda, M. D. , Ph. D. Hirofumi Maruyama, M. D. , Ph. D. and Shigenobu Nakamura, M. D. , Ph. D

The Third Department of Internal Medicine, Hiroshima University School of Medicine

We report a 30-year-old woman who presented symptoms of oropharyngeal palsy and glove-stocking type sensory disturbance followed by acute cerebellar ataxia, the syndrome of inappropriate secretion of antidiuretic hormone (SIADH), gastroenteric symptoms, urinary disturbance and orthostatic hypotention. She did not have any preceding infection. She was diagnosed as having Guillain-Barré syndrome with autonomic failure. Autonomic failure such as sinus tachycardia and nocturnal ventricular arrhythmia in addition to motor and sensory dysfunction was palliated by immunoadsorption. During the course of her illness, there were elevations of anti-ganglioside antibodies to GT1a and GQ1b in the IgG subclass, and to GD1b and GQ1b in the IgM subclass. The elevation of anti-GD1b antibody and anti-GQ1b antibody may be pathologically related to autonomic failure, cerebellar ataxia and SIADH.

(CLINICA NEUROL, 42: 13|17, 2002)
key words: Guillain-Barré syndrome, SIADH, autonomic failure, cerebellar ataxia, anti-ganglioside antibodies

(Received: 28-May-01)