Background:

Different antiganglioside antibodies possibly mediate the pathogenesis in childhood Guillain-Barre Syndrome (GBS).

Objectives:

To study the frequency of serum antiganglioside antibodies positivity in children (1mo-12 years) with GBS.

Methodology:

Prospectively (2014-2017), children (1 month-12 years), with GBS, presenting within 4 weeks of onset were included. Clinical, electophysiological assessment and analysis of serum for antiganglioside antibodies (GM1, GM2, GM3, GD1a, GD1b, GT1b, GQ1b) was done. Anticipating the prevalence of AMAN of about 0.5 and sero-positivity of 60% in AMAN; with a 90% CI width of 0.25, a sample 84 children with GBS was obtained a-priori.

Results:

During the study period a total of 83 children (71% males) with GBS ( 47- Motor GBS) were included. 23 had AIDP, 16 had AMAN, 1 had AMSAN, in 35 the tested nerves were non-reactive, in 8 children the sub-type was unclear based on the criteria.  Nearly 3/4th of the children had a preceding infection or vaccination a median of 7-days prior to onset of symptoms. Among these 83 children, six (3-AMAN and 3- NR) were positive for one or more antiganglioside antibodies (AntiGM1 positive in 5, GD1a and GD1b in one). The overall positivity rate among all the children with GBS was 7.2% vs 1.1% (controls) and that among children with AMAN was 19%.

Conclusions

The rate of antiganglioside antibody positivity in children with GBS was very low. Possibly other antigenic targets (like glycolipid complexes) are involved in pathogenesis of majority of childhood GBS.