Serum immunoglobulins in Guillain-Barré syndrome

Serum major class immunoglobulin concentrations were measured in 162 patients with Guillain-Barré Syndrome (GBS) and 85 normal controls. Significant elevations of IgM, A and G were found in the GBS group. Forty-four of 162 GBS patients (27%) had IgM concentrations greater than two standard deviations above the control mean. GBS patients with high serum IgM were young and 68% showed serologic evidence of recent infection with DNA core agents, cytomegalovirus, Epstein-Barr virus, or Mycoplasma pneumoniae. Longitudinal studies in seven patients with elevated serum IgM revealed that clinical improvement was accompanied by a marked decline in serum IgM. IgA and IgG changes were less consistent. Our findings indicate that the serum immunoglobulin response in GBS is polyclonal and follows the usual pattern seen in infections and other conditions with an immune component.