CIDP OR mmn? Reference Ranges for GM1 Ganglioside Antibodies

June 6, 2011 at 1:57 pm

Hello Blake, Yes, welcome

Note: MMN = multifocal motor neuropathy.

You don’t mention the results of EMG/NCV (Electromyography/Nerve Conduction Velocity) testing. If you have those results, please share.

If not, it raises the question- How was diagnosis made? Here is an excerpt from a GBS-CIDP newsletter:


Diagnosing CIDP
David S. Saperstein, M.D.,
Phoenix Neurological Associates, Phoenix, Arizona

“[I]…When evaluating a patient for possible CIDP, the two most important tools are the information obtained by (1) speaking with and examining the patient and (2) studying nerves with a test called an electromyogram (or EMG)…[/I]”

Unfortunately, neither the article nor the link contains a date that I could find. It is not important. I reckon the data, as stated, would be relatively unchanged if it were authored today.

Regarding the Ganglioside (asialo-GM1) Antibody, IgG/IgM, you say you have been reading the Washington University St. Louis link I sent to you. Here are some reference ranges from The University of Iowa (UIHC), Department of Pathology, LABORATORY SERVICES HANDBOOK Dated 11/10/2010:

“…[I]Reference Range:
Ganglioside (asialo-GM1) Antibody, IgG/IgM
29 IV or less: Negative
30-50 IV: Equivocal
51-100 IV: Positive
101 IV or greater: Strong Positive

If you compare that to the WU literature at


which states, in part: “…Interpretation

Dx of immune neuropathy
[COLOR=”Red”]Distinguish MMN vs CIDP[/COLOR] & ALS

Prognosis: Not ALS;
Slow progression

Cytoxan or HIG often useful
Prednisone not useful

Follow-up: Cytoxan Rx
* anti-GM1 titer ® ? relapse …[/I]”

However, according to the NIH (All NINDS-prepared information is in the public domain and may be freely copied.)

“[I]…Is there any treatment?

Treatment for multifocal motor neuropathy varies. Some individuals experience only mild, modest symptoms and require no treatment. For others, treatment generally consists of intravenous immunoglobulin (IVIg) or immunosuppressive therapy with cyclophosphamide.

What is the prognosis?

Improvement in muscle strength usually begins within 3 to 6 weeks after treatment is started. Most patients who receive treatment early experience little, if any, disability. However, there is evidence of slow progression over many years… [/I]”

Please note that Prednisone (or any steroid, in my opinion) is not an option for treatment of MMN. You state you’ve had one dose of IVIG. Refer to what the NIH says- improvement usually begins in 3 to 6 weeks. Be patient. On the other hand, you must make sure you get enough IVIG often enough. Work closely with your doctor by keeping a log of your condition. Report declines immediately.

Let us know how it goes after you’ve been to a center of excellence.

By the way- did your doctor express concern about a level of 75 on the IgM? It could be that level is considered unremarkable.

Afterall, I am not a doctor.

Good luck.