title: Anti-Ma and anti-Ma2-associated paraneoplastic neurological syndromes.
abstract: OBJECTIVE
  Analyse the clinical profile, associated tumour types, and response to treatment of paraneoplastic neurological syndromes associated with antibodies against Ma proteins.
  
  
  METHODS
  A retrospective study of patients with antibodies against Ma proteins identified in a neuroimmunology laboratory of reference.
  
  
  RESULTS
  Of the 32 patients identified, 20 showed reactivity against Ma2 only (anti-Ma2 antibodies), 11 against Ma1 and Ma2 (anti-Ma antibodies), and 1 with reactivity against Ma1 only (anti-Ma1 antibodies). The most common clinical presentations were limbic encephalopathy, diencephalic dysfunction, or brainstem encephalopathy, frequently appearing as a combination of these features. Three patients had isolated cerebellar dysfunction with anti-Ma antibodies, and 2 exhibited peripheral nervous system syndrome with anti-Ma2 antibodies. Testicular tumours were the most common neoplasms (40%) in the anti-Ma2 cases. In the group associated with anti-Ma1 antibodies, the most common were lung tumours (36%), followed by testicular tumours. All idiopathic cases were reactive to Ma2. The clinical outcome was significantly better in the anti-Ma2 group. The patient with anti-Ma1 presented with limbic encephalitis and brainstem dysfunction associated with lymphoepithelioma of the bladder.
  
  
  CONCLUSIONS
  Specifically determining the different reactivities of anti-Ma protein antibodies in order to differentiate between Ma1 and Ma2 antibodies is important because anti-Ma2-associated paraneoplastic syndromes have a better outcome. Lastly, this study is the first to confirm that there may be cases that react exclusively to antibodies against Ma1.
authors.affiliation: Servicio de Neurología, Hospital Clínico San Carlos, Madrid, España. Electronic address: gloria271187@hotmail.com.
authors.forename: G
authors.initials: G
authors.lastname: Ortega Suero
authors.affiliation: Servicio de Neurología, Hospital Clínic, Barcelona, España.
authors.forename: N
authors.initials: N
authors.lastname: Sola-Valls
authors.affiliation: Servicio de Neurología, Hospital Clínic, Barcelona, España.
authors.forename: D
authors.initials: D
authors.lastname: Escudero
authors.affiliation: Servicio de Neurología, Hospital Clínic, Barcelona, España.
authors.forename: A
authors.initials: A
authors.lastname: Saiz
authors.affiliation: Servicio de Neurología, Hospital Clínic, Barcelona, España.
authors.forename: F
authors.initials: F
authors.lastname: Graus
mesh_terms: D000941:Antigens; D000951:Antigens, Neoplasm; D001323:Autoantibodies / Q000032:analysis*; D001927:Brain Diseases; D001933:Brain Stem / Q000473:pathology; D005260:Female; D006801:Humans; D020363:Limbic Encephalitis / Q000175:diagnosis* / Q000276:immunology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000175:diagnosis; D009419:Nerve Tissue Proteins / Q000276:immunology; D012189:Retrospective Studies; D013030:Spain
chemical_list: D000941:Antigens; D000951:Antigens, Neoplasm; D001323:Autoantibodies; C117985:Ma1 antigen; C119249:Ma2 antigen; D009419:Nerve Tissue Proteins
keywords: Anti-Ma; Anti-Ma2; Anticuerpos onconeuronales; Encefalitis límbica; Limbic encephalitis; Onconeural antibodies; Paraneoplastic neurological syndromes; Síndromes neurológicos paraneoplásicos