Paraneoplastic neurological antibodies: a laboratory experience.
Antineuronal antibodies are associated with rare paraneoplastic neurological syndromes, and their identification alerts clinicians to examine for the presence of a tumor. Presented here is laboratory experience (prevalence, difficulties, and procedures) and several interesting but inconclusive results. A total of 1045 samples were screened over a 2-year period; 91 showed a degree of binding of antibodies to the cerebellum, and 22 of these 91 were confirmed, by Western blot, to have specific antineuronal antibodies. Thirteen of 22 were Hu-positive, and 6 of these also had antinuclear antibodies. Six were Yo-positive, 2 had anti-Ma antibodies, and 1 was Tr-positive. An additional 27 of 91 patients had cerebellar antibodies giving recognized staining patterns (Hu, Yo, and Ma). However, Western blot did not confirm these specificities, and hence they were reported as atypical. Six of 27 of these patients had neoplasms; 3 of the 6 gave nucleolar patterns (not Ma). Two appeared similar to Yo, and 1 similar to Hu. Antineuronal antibodies are rare, and in the absence of a specific etiology patients should be examined further for the possible presence of an underlying tumor. Methodical classification of the antibodies must be conducted to avoid incorrect reporting. Further criteria on the typing/reporting of atypical results may aid diagnosis of paraneoplastic neurological syndromes.
Karim
Abid R
AR
Department of Neuroimmunology, The Medical School, Edgbaston, Birmingham B15 2TT, United Kingdom. a.r.karim@bham.ac.uk
Hughes
Richard G
RG
Winer
John B
JB
Williams
Adrian C
AC
Bradwell
Arthur R
AR
D000974:Antibodies, Antinuclear / Q000276:immunology; D000912:Antibodies, Neoplasm / Q000378:metabolism; D001323:Autoantibodies / Q000032:analysis*; D015153:Blotting, Western; D002531:Cerebellum / Q000276:immunology; D019411:Clinical Laboratory Techniques; D019793:Fluorescein; D019084:Fluorescent Antibody Technique, Indirect; D006801:Humans; D007150:Immunohistochemistry; D009474:Neurons / Q000276:immunology*; D020361:Paraneoplastic Syndromes, Nervous System / Q000453:epidemiology / Q000276:immunology* / Q000473:pathology; D015995:Prevalence; D012189:Retrospective Studies; D006113:United Kingdom / Q000453:epidemiology
D000974:Antibodies, Antinuclear; D000912:Antibodies, Neoplasm; D001323:Autoantibodies; D019793:Fluorescein