The Clinical Research About Anti-GM₁Antibodies In Hand-Foot-Mouth Disease With Acute Flaccid Paralysis

Background:The incidence of Hand-foot-mouth disease (HFMD) has been on the rise in the past few years. The proportion of critically ills and death is increasing year by year, and the patients with acute flaccid paralysis (AFP) are more than before.Objective:To investigate the relationship between anti-GM1antibodies and immune-mediated neuropathy and the treatment responsible for the HFMD with AFP.Method:1. To collect the data of11clinical cases, who were diagnosed HFMD with AFP in Children’s Hospital of Chongqing Medical University from January2010TO December2011.2.To analysis the clinical data of11patients, including clinical manifestation, spinal magnetic resonance imaging(MRI), Peripheral nerve electrophysiology results, treatment schedule and follow-up condition.3.Serum samples from6of11patients who were diagnosed HFMD with AFP between June2010and December2011, and6healthy controls were tested, meantime, the treatment program of the6patient was collected.Results:1.The result of spinal MRI and peripheral nerve function test is abnormal.2.The level of anti-GM1antibodies was higher in patients with HFMD with AFP than control group.3.The level of the anti-GM1was lower in the patients who had used IVIG(intravenous immune globulin).Conclusions:1.The peripheral nerve injure of HFMD with AFP mainly show proximal motor nerve(Ventral horn of spinal cord or nerve roots), with or without nerve demyelination or axonal damage, some can be combined with sensory nerve injury.2. Peripheral nerve function test can early detection peripheral neuropathy in HFMD with AFP, which is more sensitive than spinal MRI.3.The injury of peripheral nerve may have an immune-mediated neuropathy which may be related to anti-GM1.4. The combined IVIG and corticoid may be an effective treatment, which not only can relieve acute symptoms, but can reduce the level of anti-antibodies, promoting the recovery of paralysis.