Diagnostic value of anti-neuronal antibodies for paraneoplastic disorders of the nervous system.
The diagnostic value of the presence of anti-neuronal antibodies in serum was examined in 21 patients suspected of paraneoplastic disorders of the nervous system (NS) (group 1) and was compared to three control groups; group 2: 25 patients with a neurological disease, without cancer and no sign of paraneoplastic disorder; group 3: 27 patients with neurological disease and cancer and no signs of a paraneoplastic disorder; group 4: 94 patients with cancer and without neurological disease. In group 1, anti-neuronal nuclear antibodies were detected in eight patients (38%), in titres from 1:1000 to 1:32,000. A small cell lung cancer was present in six patients, ovarian cancer in one patient and in one patient no tumour could be detected. The neurological symptoms preceded a diagnosis of cancer in five out of eight patients. Anti-neuronal antibodies were found in the serum of two out of 94 patients (2%) from control group 3 but not in serum from any of the other control groups. These data indicate a moderate sensitivity of 38%, but a high specificity of 98.6% (95% confidence interval 95.5-99.8%) for the presence of anti-neuronal nuclear antibodies if a paraneoplastic NS disorder is suspected.
Moll
J W
JW
Department of Neurology, Dr Daniel den Hoed Cancer Center, Rotterdam, The Netherlands.
Henzen-Logmans
S C
SC
Splinter
T A
TA
van der Burg
M E
ME
Vecht
C J
CJ
D001323:Autoantibodies / Q000032:analysis*; D001921:Brain / Q000276:immunology / Q000473:pathology; D001927:Brain Diseases / Q000175:diagnosis* / Q000276:immunology / Q000473:pathology; D018288:Carcinoma, Small Cell / Q000175:diagnosis / Q000276:immunology / Q000473:pathology; D005260:Female; D005455:Fluorescent Antibody Technique; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis / Q000276:immunology / Q000473:pathology; D009420:Nervous System / Q000276:immunology / Q000473:pathology; D009422:Nervous System Diseases / Q000175:diagnosis* / Q000276:immunology / Q000473:pathology; D009474:Neurons / Q000276:immunology*; D010051:Ovarian Neoplasms / Q000175:diagnosis / Q000276:immunology / Q000473:pathology; D010257:Paraneoplastic Syndromes / Q000175:diagnosis* / Q000276:immunology / Q000473:pathology
D001323:Autoantibodies