Guillain–Barré syndrome with antibodies to GD1a/GD1b complex

Recently, ganglioside complexes (GSCs) such as GD1a/GD1b, GD1a/GM1, GD1b/GT1b, GM1/GT1b, GQ1b/GM1 and GQ1b/GD1a have been shown as target antigens for serum antibodies in patients with Guillain–Barre syndrome (GBS)1 and Miller Fisher syndrome (MFS).2 Gangliosides may interact with each other to form a novel epitope, which serves as a target antigen for serum antibodies.1 In paticular, anti-GD1a/GD1b IgG is reported to be associated with severe GBS and requirement of mechanical ventilation.1 However, there has been no previous case report describing GBS with anti-GSC antibodies in detail. In this report, we present a patient with GBS having anti-GD1a/GD1b antibody and investigated the clinical feature. A 42-year-old man noticed weakness of the bilateral upper extremities 2 weeks after an episode of acute respiratory tract symptoms and diarrhoea. His symptoms further developed to dysarthria, dysphagia and tetraparesis, and he was admitted to the Department of Neurology, Ishikawa Prefecture …