Clinical usefulness of Anti-ganglioside antibody in children with neurologic disease: single center study

Clinical usefulness of Anti-ganglioside antibody in children with neurologic disease: single center study Purpose: Ganglioside antibodies are known to be related to central nervous system diseases such as Gullain-Barre syndrome, and Miller-Fisher syndrome or other illnesses with neurologic symptoms like motor weakness, ataxia, changed mental status, diplopia, and dizziness. In this study the utility of anti-ganglioside antibody titer as a diagnostic marker and its correlation with clinical course in pediatric patients were investigated. Methods: From October 2010 to Apirl 2016, anti-ganglioside antibody panel was performed in 42 patients with one of these symptoms: ataxia, motor weakness, changed mental status, diplopia. The panel was composed of 6 subtypes of antiganglioside antibodies: Anti-GM1 IgG/IgM, Anti-GD1b IgG/IgM, Anti-GQ1b IgG/ IgM. The results were compared with other aspects of clinical diagnostic studies including Brain magnetic resonance imaging(MRI), electroencephalogram(EEG), cerebrospinal fluid examination and routine laboratory work-up Results: Among 42 patients, total 11 patients showed positivity on antiganglioside antibody. Among anti-ganglioside antibody positive patients, brainstem encephalitis were the most common followed by Gullain-Barre syndrome, acute opthalmoplegia without ataxia, acute disseminated encephalitis, encephalitis and Tolosa-Hunt syndrome. Subtypes of ganglioside antibodies are investigated in each diseases, but not like previous datas, subtypes were varied case by case in same disease, showing lack of correlation. Conclusion: Anti-ganglioside antibody panel exam was useful in diagnosing brainstem encephalitis and several other neurologic illnesses with cerebellar symptoms. Also, unlike previously known adult data, positivity of anti-ganglioside antibodies in GBS was relatively low in children (20%). However, further study might be done to clarify connections between antiganglioside antibodies titer and the clinical course of the diseases.