Routine diagnostics for neural antibodies, clinical correlates, treatment and functional outcome
| العنوان: | Routine diagnostics for neural antibodies, clinical correlates, treatment and functional outcome |
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| المؤلفون: | Wolf-Rüdiger Schäbitz, Verena Eigler, Fatme Seval Ismail, Martin Kurthen, Olga Simova, Corinna I. Bien, Carl-Albrecht Haensch, Christian G. Bien, Romana Höftberger, Andrea O. Rossetti, Müjgan Dogan Onugoren, Nico Melzer, Helmut Rauschka, Desiree De Simoni, Felix von Podewils, Martin Holtkamp, Kristina Mayer, Karsten Witt, Theodor W. May |
| المصدر: | Journal of Neurology Journal of neurology, vol. 267, no. 7, pp. 2101-2114 |
| بيانات النشر: | Springer Berlin Heidelberg, 2020. |
| سنة النشر: | 2020 |
| مصطلحات موضوعية: | Male, 0301 basic medicine, Neuropil, Neurology, medicine.medical_treatment, Receptors, Glycine, 0302 clinical medicine, Cerebrospinal fluid, Interquartile range, Autoimmune encephalitis, Child, Outcome, Aged, 80 and over, Original Communication, biology, Glutamate Decarboxylase, Mental Disorders, Intracellular Signaling Peptides and Proteins, Antibody titer, Middle Aged, Titer, Potassium Channels, Voltage-Gated, Child, Preschool, Female, Immunotherapy, Antibody, Adult, medicine.medical_specialty, Adolescent, Neural autoantibodies, Diagnostic Techniques, Neurological, Nerve Tissue Proteins, Immunologic Tests, Receptors, N-Methyl-D-Aspartate, Young Adult, 03 medical and health sciences, Autoimmune Diseases of the Nervous System, Internal medicine, medicine, Humans, Receptors, AMPA, Laboratory test evaluation, ddc:610, Aged, Autoantibodies, Retrospective Studies, business.industry, Infant, Membrane Proteins, Reproducibility of Results, Correction, HEK293 Cells, 030104 developmental biology, Receptors, GABA-B, biology.protein, Neurology (clinical), business, 030217 neurology & neurosurgery |
| الوصف: | Objective To determine frequencies, interlaboratory reproducibility, clinical ratings, and prognostic implications of neural antibodies in a routine laboratory setting in patients with suspected neuropsychiatric autoimmune conditions. Methods Earliest available samples from 10,919 patients were tested for a broad panel of neural antibodies. Sera that reacted with leucine-rich glioma-inactivated protein 1 (LGI1), contactin-associated protein-2 (CASPR2), or the voltage-gated potassium channel (VGKC) complex were retested for LGI1 and CASPR2 antibodies by another laboratory. Physicians in charge of patients with positive antibody results retrospectively reported on clinical, treatment, and outcome parameters. Results Positive results were obtained for 576 patients (5.3%). Median disease duration was 6 months (interquartile range 0.6–46 months). In most patients, antibodies were detected both in CSF and serum. However, in 16 (28%) patients with N-methyl-d-aspartate receptor (NMDAR) antibodies, this diagnosis could be made only in cerebrospinal fluid (CSF). The two laboratories agreed largely on LGI1 and CASPR2 antibody diagnoses (κ = 0.95). The clinicians (413 responses, 71.7%) rated two-thirds of the antibody-positive patients as autoimmune. Antibodies against the α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptor (AMPAR), NMDAR (CSF or high serum titer), γ-aminobutyric acid-B receptor (GABABR), and LGI1 had ≥ 90% positive ratings, whereas antibodies against the glycine receptor, VGKC complex, or otherwise unspecified neuropil had ≤ 40% positive ratings. Of the patients with surface antibodies, 64% improved after ≥ 3 months, mostly with ≥ 1 immunotherapy intervention. Conclusions This novel approach starting from routine diagnostics in a dedicated laboratory provides reliable and useful results with therapeutic implications. Counseling should consider clinical presentation, demographic features, and antibody titers of the individual patient. |
| وصف الملف: | application/pdf |
| اللغة: | English |
| تدمد: | 1432-1459 0340-5354 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::f809fbceb949dd5021be9401ac6f0f7a http://europepmc.org/articles/PMC8213550 |
| Rights: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....f809fbceb949dd5021be9401ac6f0f7a |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 14321459 03405354 |
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