Clinical Characteristics Of Anti-NF155 IgG Antibody Positive Patients With Guillain-Barre Syndrome In Southwest Shandong Province

Objective: To investigate the positive rate of anti-NF155 IgG antibody in 226 patients with Guillain-Barre syndrome(GBS)in southwest China,and compare the positive and negative clinical characteristics of anti-NF155 IgG antibody in GBS patients.Methods: A total of 226 patients with GBS in southwest Shandong Province were included.In the control group,226 patients with other neurological disease(OND)matching gender and age and226 healthy subjects were selected.The anti-NF155 IgG antibody in serum of GBS patients was detected by mouse sciatic nerve single fiber immunofluorescence and cell immunofluorescence.Results: The median age of onset of 226 patients with GBS in this study was 56 years old(interquartile interval,44-66),and the male-tofemale ratio was 1.2:1.46%(73/226)of the patients had a history of preinfection 4 weeks before onset.The main clinical symptoms were symmetrical limb weakness(82.7%).Among 226 GBS patients,20 patients with positive paranodal antibodies were detected by single fiber immunofluorescence,and 9 patients with positive anti-NF155 IgG antibody were screened by cellular immunofluorescence.The anti-NF155 IgG antibody was negative in both OND and healthy controls.In this study,the electrophysiological type of GBS patients with anti-NF155 IgG antibody positive was mainly demyelination type(55.5%,5/9),clinical manifestations were bilateral delayed paralysis of limbs symmetry(66.7%,6/9)and paresthesia(44.4%,4/9),22%(2/9)patients were accompanied by ataxia.Cerebrospinal fluid protein-cell separation was present in 66.7%(6/9)of patients,and 66.7%(4/6)responded to intravenous immunoglobulin.Compared with the study in North China,there were no significant differences in age of onset,preinfection,sensory involvement,cranial nerve involvement and cerebrospinal fluid protein-cell separation among GBS patients with anti-NF155 IgG antibody positive in southwest Shandong Province(P > 0.05).In terms of electrophysiological typing,in this study,demyelinating type was dominant in patients with positive antibody,while axonal type was dominant in patients with positive antibody in North China(P < 0.05).The proportion of patients with ataxic symptoms in this study was higher than that in North China(22.2%vs 0,P< 0.05).In this study,the GDS and m EGOS of antibody-positive patients after treatment were significantly lower than those in North China(P <0.001).Conclusion: 3.9%(9/226)of GBS patients in southwest Shandong were positive for NF155 IgG antibody.No clinical features related to antiNF155 IgG were found in GBS patients in southwest Shandong Province.In terms of age of onset and proinfcetion,this study was similar to that of patients with positive anti-NF155 IgG antibody in North China,but there were differences in electrophysiological typing,accompanying symptoms,therapeutic effect and prognosis.The results of this study need to be confirmed with a larger sample size.