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Composite ganglioside autoantibodies and immune treatment response in MMN and MADSAM

Martinez-Thompson, JM, Snyder, MR, Ettore, M, McKeon, A, Pittock, SJ, Roforth, MM, Mandrekar, J, Mauermann, ML, Taylor, BV, Dyck, PJB, Windebank, AJ and Klein, CJ 2018 , 'Composite ganglioside autoantibodies and immune treatment response in MMN and MADSAM' , Muscle and Nerve, vol. 57, no. 6 , pp. 1000-1005 , doi: 10.1002/mus.26051.

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Abstract

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.

Item Type: Article
Authors/Creators:Martinez-Thompson, JM and Snyder, MR and Ettore, M and McKeon, A and Pittock, SJ and Roforth, MM and Mandrekar, J and Mauermann, ML and Taylor, BV and Dyck, PJB and Windebank, AJ and Klein, CJ
Keywords: CIDP, MADSAM, MMN, gangliosides
Journal or Publication Title: Muscle and Nerve
Publisher: John Wiley & Sons Inc
ISSN: 0148-639X
DOI / ID Number: 10.1002/mus.26051
Copyright Information:

Copyright 2017 Wiley Periodicals, Inc.

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