184 - Diagnostic accuracy of methods for the detection of antineuronal antibodies in paraneoplastic neurological syndromes
Autor(s): M. Tampoia, A. Antico, C. Bonaguri, M.G. Alessiod, A. Zucano, A. Radice, S. Platzgummer, N. Bizzaro
Issue: RIMeL - IJLaM, Vol. 4, N. 3, 2008 (MAF Servizi srl ed.)
Page(s): 184-191
Background. The presence in serum and cerebrospinal fluid (CSF) of antineuronal antibodies supports the diagnosis of paraneoplastic neurological syndromes (PNSs). We evaluated the diagnostic accuracy of three different methods used in clinical laboratories. Methods. 94 sera of patients with neurological diseases were studied; 28 from patients with PNS, 44 from patients with other neurological disease, 22 from patients with systemic autoimmune diseases and neurological disorders. The control group consisted of 20 healthy subjects and 18 subjects with tumour without neurological disorders. Antineuronal antibodies were tested by indirect immunofluorescence (IIF) on cerebellum of primate, Western-blot (WB) and line-blot (LB) methods. Antinuclear antibodies (ANA) were tested by the IIF method on HEp-2 cells. Results. Sensitivity and specificity of the IIF, WB and LB methods were 17.8% and 97.8%, 17.8% and 91.4%, 21.4% and 96.8%, respectively. The diluition factor and the detection of ANA increased the specificity of the IIF method. When IIF and LB were assayed together, sensitivity was 25% and specificity 95.7%. Conclusions. The data show that all methods for the detection of antineuronal antibodies have good specificity. The IIF test on cerebellum of primate does not allow the identification of fine antibody specificities. The LB test allows the identification of some antibodies and shows higher sensitivity than the other methods. These diagnostic properties propose LB as the most accurate method for the detection of antineuronal antibodies