頁籤選單縮合
題名 | Clinical and Pathophysiological Features of Autoimmune Neuropathies Related to Anti-glycolipid Antibodies |
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作者姓名(外文) | Willison, Hugh J.; | 書刊名 | Acta Neurologica Taiwanica |
卷期 | 9:4 民89.12 |
頁次 | 頁266-272 |
分類號 | 415.9 |
關鍵詞 | 自體免疫神經病變; Autoimmune neuropathy; Anti-glycolipid antibody; Miller fisher syndrome; |
語文 | 英文(English) |
英文摘要 | Recent years have seen major progress in our understanding of the clinical pathophysiology of autoimmune neuropathies. The most productive advances in this area have come from the identification and analysis of antibodies to gangliosides and related glycolipids in the serum of patients with acute and chronic peripheral nerve disorders. Anti-glycolipid antibodies react with epitopes on the carbohydrate region of glycolipid molecules and can be routinely measured by standard immunoassays. In multifocal motor neuropathy IgM anti-GM1 antibodies (which cross react with GD1b and GA1) are detectable in around 50% of cases. This condition may be clinically confused with certain forms of lower motor neurone disease. IgM anti-GD1b antibodies are found in a form of IgM paraproteinaemic neuropathy characterized by profound ataxia. In the anti-MAG IgM paraproteinaemic neuropathy, antibodies also react with the acidic glycolipids, SGPG and SGPLG. Thus a variety of chronic syndromes can be defined by their anti-glycolipid antibody profile. In Guillain Barre syndrome, anti-GM1a, GM1b, GD1a and GalNAc-GD1a antibodies are found in patients with acute motor axonal neuropathy (AMAN) and anti-GQ1b IgG antibodies are a very sensitive and specific marker for the Miller Fisher syndrome. Many other anti-glycolipid antibodies are being increasingly identified in other neuropathy subtypes. Pathophysiological studies are beginning to provide good evidence that these antibodies are important mediators of neural injury. This presentation will summarise existing clinical, serological and pathophysiological information in this rapidly advancing field. |
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