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Composite ganglioside autoantibodies and immune treatment response in MMN and MADSAM

journal contribution
posted on 2023-05-19, 17:32 authored by Martinez-Thompson, JM, Snyder, MR, Ettore, M, McKeon, A, Pittock, SJ, Roforth, MM, Mandrekar, J, Mauermann, ML, Bruce TaylorBruce Taylor, Dyck, PJB, Windebank, AJ, Klein, CJ
Introduction: Multifocal motor neuropathy (MMN) is a motor only, asymmetric onset neuropathy that is relatively treatment-refractory compared with classic chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) and multifocal acquired demyelinating sensory and motor (MADSAM) neuropathy.

Methods: We reviewed 35 patients seropositive for GM1 (monosialo-asialo [immunoglobulin M, IgM; immunoglobulin G, IgG]) and/or GD1b (disialo [IgG, IgM]) autoantibodies having MMN, classic CIDP, or MADSAM. Immune-treatment responsiveness and clinical course was compared with antibody negative disease controls.

Results: Seventy-nine percent of seropositives with an initial diagnosis of MMN were immunotherapy responsive compared with 46% of seronegatives (P = 0.045). Eight ganglioside antibody positive MMN patients of 19 (42%) developed sensory findings consistent with MADSAM compared with 3 of 41 (7%) seronegative MMN patients (P = 0.003). MMN and MADSAM patients with ganglioside antibody positivity had more sustained treatment responses (P = 0.03).

Discussion: Patients initially diagnosed with MMN seropositive for diverse GM1 autoantibodies appear more likely to have sustained treatment response and evolution to MADSAM.

History

Publication title

Muscle and Nerve

Volume

57

Issue

6

Pagination

1000-1005

ISSN

0148-639X

Department/School

Menzies Institute for Medical Research

Publisher

John Wiley & Sons Inc

Place of publication

111 River St, Hoboken, USA, Nj, 07030

Rights statement

Copyright 2017 Wiley Periodicals, Inc.

Repository Status

  • Restricted

Socio-economic Objectives

Clinical health not elsewhere classified

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