Anti-glycolipid antibodies in patients with neuropathy: a diagnostic assessment

Anti-glycolipid antibodies are associated with immune-mediated neuropathies and screening is often performed as part of the diagnostic assessment for patients presenting with peripheral neuropathy. We report our experience in testing for immunoglobulin (Ig) G and IgM anti-glycolipid (GM1, GM2, GM3, GM4, GD1a, GD1b, GD2, GD3, GT1a, GT1b, GQ1b, sulfatides) antibodies in 290 consecutive patients presenting with neuropathy. Anti-glycolipid antibodies were detected significantly more often (43%) in patients who were diagnosed with definite immune-mediated neuropathy than in patients without a final diagnosis of immune-mediated neuropathy (control group) (23%). With positive and negative predictive values of 22% and 90%, respectively, anti-glycolipid antibodies are not a very reliable diagnostic tool in early patient contact. Certain antibodies (IgM to GM2, GT1a and IgG to GM3, GD3 and GT1b) were equally or more prevalent in the control group; clinicians should be aware of this distribution when receiving positive screening results for these antibodies. Concomitant IgG and IgM reactivities were found for GM1, GM2, GD1b and sulfatides, and were detected more frequently in patients with definite immune-mediated neuropathies.