title: Utility of Paraneoplastic Antibody Testing in the Diagnosis of Motor Neuron Disease.
abstract: OBJECTIVE
  To evaluate the role of paraneoplastic autoantibody testing in the diagnosis of motor neuron disease (MND).
  
  
  BACKGROUND
  There have been rare case reports of paraneoplastic MND that have prompted many physicians to test for paraneoplastic autoantibodies in patients with MND. Our study is the first to determine the utility of such testing.
  
  
  METHODS
  Retrospective chart review of patients with MND from a tertiary referral center from 2007 to 2014.
  
  
  RESULTS
  Of 316 patients with MND reviewed, 44% (n = 138) were evaluated by a Mayo Clinic paraneoplastic autoantibody panel. Of note, 73% of these patients (n = 101) were diagnosed with amyotrophic lateral sclerosis, fulfilling possible, probable, or definite revised El Escorial criteria. Of note, 9% of patients (13/138) of those who had paraneoplastic antibody testing performed were positive for at least 1 paraneoplastic antibody. Three patients had negative testing for malignancy. None had a different disease course than expected.
  
  
  CONCLUSIONS
  Testing for paraneoplastic antibodies does not seem to change the diagnosis, management, or outcome in the setting of MND and is therefore of limited value.
authors.affiliation: *Department of Neurology, University of Washington, Seattle, WA; †Department of Laboratory Medicine, University of Washington, Seattle, WA; and ‡Department of Medicine, University of Washington, Seattle, WA.
authors.forename: Najwa
authors.initials: N
authors.lastname: Al-Bustani
authors.forename: William
authors.initials: W
authors.lastname: Simonson
authors.forename: Desiree A
authors.initials: DA
authors.lastname: Marshall
authors.forename: Jennifer
authors.initials: J
authors.lastname: Vetrovs
authors.forename: Mark H
authors.initials: MH
authors.lastname: Wener
authors.forename: Michael D
authors.initials: MD
authors.lastname: Weiss
authors.forename: Leo H
authors.initials: LH
authors.lastname: Wang
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000906:Antibodies / Q000378:metabolism*; D020864:Calcium Channels, N-Type / Q000276:immunology; D003402:Creatine Kinase / Q000097:blood; D004576:Electromyography; D005260:Female; D005968:Glutamate Decarboxylase / Q000276:immunology; D006801:Humans; D008297:Male; D008875:Middle Aged; D016472:Motor Neuron Disease / Q000145:classification / Q000175:diagnosis*; D010257:Paraneoplastic Syndromes / Q000150:complications / Q000276:immunology; D024642:Potassium Channels, Voltage-Gated / Q000276:immunology; D011978:Receptors, Nicotinic / Q000276:immunology; D012189:Retrospective Studies
chemical_list: D000906:Antibodies; D020864:Calcium Channels, N-Type; D024642:Potassium Channels, Voltage-Gated; D011978:Receptors, Nicotinic; D003402:Creatine Kinase; D005968:Glutamate Decarboxylase; C401141:glutamate decarboxylase 2