A 49-year-old man presented with
hoarseness,
dysphagia,
muscle atrophy and weakness of deltoid, trapezius, sternocleidomastoid, rhomboid, anterior serratus, infraspinatus and supraspinatus. Anti-Gal-C
IgM antibody was positive in the serum. The other antiganglioside
antibodies (GM1, GM2, GM3, GD1a, GD1b, GD3, GT1a, GT1b, GQ1b, GA1, GalNAc-GD1a,
GM1b) were negative. Patient contracted
pneumonia but whether it was due to mycoplasma was not evident.
Plasmapheresis improved his clinical state including a decrease of the antibody. This case was diagnosed pharyngeal-cervical-brachial variant of
Guillain-Barré syndrome, and anti-Gal-C antibody seemed to be correlated with the pathogenesis of this syndrome. Gal-C is a major
glycolipid of myelin and the cell membrane of the myelin-forming cell (oligodendrocytes and Schwann cells) and is free of specific localization and distribution. The mechanism how the anti-Gal-C
IgM antibody induced
bulbar paralysis and the symptoms localizing neck and upper limbs remains to be known.