Immunoglobulins in serum and cerebrospinal fluid from patients with acute Guillain-Barré syndrome

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Abstract
IgG, IgA, IgM and IgE were quantified in serum and IgG and total protein were quantified in cerebrospinal fluid (CSF) from 80 patients with acute Guillain-Barré syndrome. The serum concentrations of IgM and IgA were significantly increased in approximately 25% of the patients, whereas the concentrations of IgG and IgE were normal. Increased CSF concentrations of IgG were found in more than 90% of the patients and correlated with increased CSF total protein concentrations. The CSF IgG/total protein ratio, CSF IgG index and Tourtellotte's formula were used to determine intra-thecal IgG synthesis in 30 of the patients. In eight of the patients the results of the CSF IgG index and Tourtellotte's formula were significantly increased, while in the remaining seven patients increased values were obtained using only one of these formulae. The CSF IgG/total protein ratio was normal in all the patients. Oligoclonal bands were not detected in any of the sera or CSF. Antibodies to peripheral nerve tissue were detected in approximately 30% of the patient sera, but could not be detected in the CSF.