[Axonal Guillain-Barré syndrome associated with antibodies to Ga1NAc-GD1a and unidentified acidic glycolipids].

A 19-year-old male student with Guillain-Barré syndrome (GBS) was described. Neurologic examination revealed severe and moderate degrees of weakness in the distal and proximal muscles, respectively, in both upper and lower limbs. He was unable to walk even with support. Both superficial and deep sensations were normal. Serial electrophysiologic studies indicated that the predominant pathologic process of the peripheral nerve was axonal degeneration of motor nerves. Enzyme-linked immunosorbent assay showed that serum from the patient had markedly high titer of IgG antibody to Ga1NAc-GD1a (1:204,800). Thin-layer chromatography with immunostaining revealed that his serum IgG strongly reacted with Ga1NAc-GD1a prepared from both bovine brain and cauda equina, and additionally with unidentified acidic glycolipids prepared only from bovine cauda equina. Serum containing antibody to Ga1 NAc-GD1a and the unidentified acidic glycolipids may be responsible for axonal degeneration of motor nerves in this patient.