Antibodies to gangliosides are associated with a number of autoimmune peripheral neuropathies. Gangliosides are complex glycolipids found most commonly in the brain and nervous tissue. The specific carbohydrates which are recognised by these antibodies are also found in infectious organisms such as campylobacter which can trigger some of these diseases. The autoantibodies are believed to be pathogenic. Guillain-Barre syndrome is characterised by the presence of antibodies to membrane gangliosides including GM1, asialoGM1, LM1 and GD1b. Antibodies to peripheral nerve sulphated glucuronyl paragloboside cross react with myelin associated glycoprotein (MAG).
Diagnosis of motor neuropathies; GBS, AMAN, multifocal motor neuropathies, CIDP, Miller-Fisher syndrome, CANOMAD.
Anti-glycolipid antibodies are associated with several distinct peripheral nerve syndromes: Multifocal motor neuropathy is associated with anti-GM1, -GA1 and -GD1b IgM antibodies. Chronic ataxic neuropathy with ophthalmoplegia M-protein, cold agglutination, and disialosyl antibodies (acronym: CANOMAD) is associated with anti-GD1b and related IgM antibodies. Miller Fisher syndrome is associated with anti-GQ1b and -GT1a IgG antibodies. The Guillain–Barré Syndrome variant Acute motor axonal neuropathy (AMAN) is associated with anti-GM1 and -GD1a IgG antibodies.
Serum Separator Tube (SST)
Referred test: only available to neurology staff.
Glasgow Neuroimmunology Laboratory, Queen Elizabeth University Hospital