asialo gm1 igm antibodies

[mabel]

Dear Doctor,

I have MG and unexplained parasthesias and loss of reflexes.  I also get rashes which the derm doc said were vasular flushes and has not been able to biopsy it yet because they usually last less than 24 hours.  My neurologist ran anti jo which was 8 and negative, but I had borderline findings of the asialo gm1 igm antibodies.  They went from under 10 to 21.2 with the previous test done 2 months prior.  Can you tell me what those antibodies could implicate?

Thank you for your time and wonderful forum

[CCF Neuro[P] MD, RPS]

Dear Betsy:

I am actually unsure what these antibodies mean in your case.  By what you indicate, you have myasthenia gravis.  In MG exacerbations we see loss of reflexes, so I am unsure why your loss of reflexes are unexplained.  We usually use the presence of asialo antibodies to determine if a person has an extremely rare type of disease called carbohydrate-deficient glycoprotien syndrome.  All of the 200 or so cases have been infants.  The occurrance of your antibodies just might be a generalized autoimmune reaction.  Likely not significant.

Sorry, I am not much help.

Sincerely,

CCF Neuro MD

[CCF Neuro[P] MD, RPS]

Dear Betsy:

As I was thinking over your posting, it came to mind that the anti GM1 antibody might be for GBS, as this antibody is elevated in a subset of Guilllian Barre patients.  But I have not heard it called anti-asial GM1 antibody.  The difference between the two diseases should have been easily identified on EMG as MG has a particular pattern when the muscle is used.

Sincerely,

CCF Neuro MD

[mabel]

Dear Doctor,

Thank you for your response.  I think the antibodies were under 10 when they did the single fiber emg on me for the MG. They tested the GM1 IGM and the asialo GM1 Igm as well as the IGG counterparts, not sure what those are but those were normal.  The only one elevated was the Asialo ones. The MAG was 8. I have had a continual loss of reflex, not consistant with MG exacerbations as I have a mild case of it according to my doctor. They found the MG when investigating for the numbness that I have in my lower legs and feet, lower abdomen and few other places.  I cannot feel water running on my ankles put i can feel pressure etc.  They ran a carbohydrate deficient transferrin test on me on the first antibody test and it was 4.6%.  They didn't repeat that test when they re-ran the GM1 Asialo antibodies. I was told a neuromuscular disease could surpress the levels of that test carbohydrate test, but I am not sure of that. I don't think I have guillian barr because I haven't become paralyzed or anything like that.  Hope this helps clarify some of that for you.

Thank you again.