Analysis of clinical, serological and cerebrospinal fluid characteristics of patients with Guillain-Barré syndrome with non-organ-specific autoantibodies / 中华神经科杂志

ABSTRACT

Objective:To investigate the clinical, serological and cerebrospinal fluid (CSF) characteristics of patients with Guillain-Barré syndrome (GBS) with positive non-organ-specific autoantibodies.Methods:Eighty-three patients with GBS admitted to the Department of Neurology and Department of Neurocritical Care of the First Affiliated Hospital of Zhengzhou University from January 2016 to December 2020 were retrospectively analyzed, including 33 patients with positive non-organ-specific autoantibodies and 50 patients with negative non-organ-specific autoantibodies. The clinical, serological and cerebrospinal fluid characteristics were compared between the two groups.Results:Thirty-three of 83 (40%) GBS patients were positive for non-organ-specific autoantibodies, and anti-Ro-52 antibody, antinuclear antibody and anti-Sj?gren syndrome A antibody were the most common non-organ-specific autoantibodies. The incidence of autonomic dysfunction (22/33, 67%), respiratory muscle involvement (10/33, 30%), cranial nerve involvement (29/33, 88%), and severe GBS (29/33,88%) was significantly higher in the non-organ-specific autoantibody positive group than in the negative group (10/50, 20%, χ2=18.28, P<0.001;5/50, 10%, χ2=5.54, P=0.019;14/50, 28%, χ2=18.20, P<0.001;28/50, 56%, χ2=9.39, P=0.002). Hyponatremia (9/33, 27% vs 4/50, 8%; χ2=5.59, P=0.018) and liver function impairment (14/33,42% vs 5/50,10%;χ2=11.84, P=0.001) were more likely to occur in the non-organ-specific autoantibody positive group than in the negative group. In addition, the cerebrospinal fluid protein content of the non-organ-specific autoantibody positive group [0.94(0.76) g/L] was significantly higher than that of the negative group [0.59(0.48) g/L, Z=-2.89, P=0.004]. There were no significant differences in gender, age of onset, presence of triggers before onset, time to peak, first symptoms, incidence of sensory disturbances and axonal involvement by electromyography, incidence of hypoproteinemia and hypokalemia, anti-ganglioside antibody positive rate, cerebrospinal fluid pressure, white blood-cell count, and sugar and chloride content between the two groups. Conclusions:GBS patients with positive non-organ-specific autoantibodies may have more extensive autoimmune reactions and more severe nerve damage, and are more likely to have systemic homeostasis disorders. The incidence of autonomic dysfunction, respiratory muscle involvement, cranial nerve involvement and severe GBS is significantly higher, the cerebrospinal fluid protein content is significantly increased, and it is more likely to be complicated with hyponatremia and liver function damage in this group of patients.