Immunoadsorption therapy for Fisher syndrome associated with IgG Anti-GQ1b antibody

PURPOSE: To describe the effects of immunoadsorption therapy with a tryptophan immobilized column on Fisher syndrome associated with IgG anti GR(1b) ganglioside antibody. METHODS: Three patients with Fisher syndrome and with a high serum IgG anti-GQ(1b) antibody titer underwent four to nine sessions of immunoadsorption therapy with a tryptophan immobilized column. Using enzyme linked immunosorbent as say (ELISA), we determined the differences in IgG anti-GQ(1b) antibody titers. RESULTS: ELISA disclosed that the IgG anti-GQ(1b) antibody titers of the serum samples collected from the inlet of the column were markedly higher than those collected from the outlet for all three patients. Moreover, after completion of the immunoadsorption therapy, the patients' serum IgG anti-GQ(1b) antibody titers were markedly lower than they were before the immunoadsorption therapy. The patients' ophthalmoparesis decreased in severity during the therapy. CONCLUSION: These findings suggest that immunoadsorption therapy with the tryptophan immobilized column is an effective method for removing IgG anti-GQ(1b) antibody from serum. (C) 1998 by Elsevier Science Inc. All rights reserved.