Clinical neuropathology practice guide 5-2012: Updated guideline for the diagnosis of antineuronal antibodies
Romana Höftberger1, Josep Dalmau2,3, Francesc Graus4
1 Institute of Neurology, Medical University of Vienna, Austria, 2 Institució Catalana de Recerca i Estudis Avançats (ICREA) – Institut d´Investigacio Biomedica August Pi i Suyer (IDIBAPS), Hospital Clinic, Barcelona, Spain, 3 Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA, and 4 Service of Neurology, Hospital Clinic-IDIBAPS, Barcelona, Spain
DOI 10.5414/NP300545
Abstract
In recent years there is an increasing description of novel anti-neuronal antibodies that are associated with paraneoplastic and non-paraneoplastic neurological syndromes. These antibodies are useful in clinical practice to confirm the immunmediated origin of the neurological disorder and are helpful in tumor search. Currently, antineuronal antibodies can be classified according to the location of the recognized antigen into two groups, 1.) intraneuronal antigens and 2.) antigens located in the cell membrane. Different techniques are established for detecting these antibodies: tissue-based assay (TBA), cell-based assay (CBA), immunoblot, immunoprecipitation assay (IP), and ELISA. TBA detect most of the antibodies, however, different pretreatment methods of rat brain are necessary to visualize either Group 1 or 2 antibodies. Higher specificity is provided by immunoblots, applicable for Group 1 antibodies, and CBA, suitable for Group 2 antibodies. IP and ELISA may be useful for the detection of specific antibodies or to solve particular issues such as antibody titers. Diagnosis of paraneoplastic and non-paraneoplastic neurological syndromes has important implications on treatment and follow-up of patients. Selection and proper combination of test systems and appropriate knowledge of the clinical information will provide a maximum of sensitivity and specificity in identifying the associated antibody.
Author Details
Authors
Departments
- 1 Institute of Neurology, Medical University of Vienna, Austria,
- 2 Institució Catalana de Recerca i Estudis Avançats (ICREA) – Institut d´Investigacio Biomedica August Pi i Suyer (IDIBAPS), Hospital Clinic, Barcelona, Spain,
- 3 Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA, and
- 4 Service of Neurology, Hospital Clinic-IDIBAPS, Barcelona, Spain
Address
Romana Höftberger, MD
Institute of Neurology, AKH 4J
Währinger Gürtel 18-20, POB 48
1097 Vienna, Austria
Email:
[email protected]
Citation
Romana Höftberger, Josep Dalmau and Francesc Graus.Clinical neuropathology practice guide 5-2012: Updated guideline for the diagnosis of antineuronal antibodies. 2012; 31: 337-341. doi: 10.5414/NP300545.
