Adie's Tonic Pupil and Anti-Ganglioside IgG Antibodies

Objective: The presence of anti-ganglioside IgG antibodies has been reported in the Guillain-Barre Syndrome (GBS) and the Miller-Fisher Syndrome (MFS). Adie's tonic pupil (ATP) is similar to GBS and its variants with the symmetric decrease in reflexes and the mydriasis that is an indicator of a parasympathetic disorder but the relationship between ATP and anti-ganglioside antibodies is unknown. Our aim in this study was to investigate the presence of anti-ganglioside IgG antibodies in patients with ATP. Patients and method: The study group consisted of a total of 20 persons with 10 patients and 10 control subjects. The control group consisted of healthy persons who did not have any problems that could influence the immune system. A neuro-ophthalmological examination was performed in all patients and the presence of anti-ganglioside antibodies in the serum was investigated. Results: Serum anti-ganglioside antibodies were negative in the 3 patients included in the study according to the review of old patient charts. Anti-GD1b, anti-GT1b and anti-GM3 antibodies were positive in 2 and anti-GM3 antibodies in 1 of the 7 patients included in the study after a new diagnosis was made. Anti-ganglioside antibodies were negative in all control group subjects. Conclusion: At least one of the anti-ganglioside antibodies was found to be positive in approximately half of the ATP patients in the acute stage (3 of the 7 acute or subacute stage ATP patients). These results indicate that anti-ganglioside antibodies may play a role in ATP development.