Comparison of fixed cell-based assay to radioimmunoprecipitation assay for acetylcholine receptor antibody detection in myasthenia gravis.
J Neurol Sci
; 432: 120084, 2022 Jan 15.
Article
en En
| MEDLINE
| ID: mdl-34906880
ABSTRACT
OBJECTIVE:
To compare specificity and sensitivity of a commercially available fixed cell-based assay (F-CBA) to radioimmunoprecipitation assay (RIPA) for acetylcholine receptor antibody (anti-AChR) detection in myasthenia gravis (MG).METHODS:
In this retrospective diagnostic cohort study we reviewed the clinical information of suspected MG patients evaluated at the London Health Sciences Centre MG clinic who had anti-AChR RIPA and then F-CBA performed, in order to classify them as MG or non-MG. Classification of each patient as anti-AChR F-CBA-negative/positive, RIPA-negative/positive, and MG/non-MG permitted specificity and sensitivity calculations for each assay.RESULTS:
Six-hundred-eighteen patients were included in study analysis. The median patient age at time of sample collection was 45.8 years (range 7.5-87.5 years) and 312/618 (50.5%) were female. Of 618 patients, 395 (63.9%) were classified as MG. Specificity of both F-CBA and RIPA was excellent (99.6% vs. 100%, P > 0.99). One F-CBA-positive patient was classified as non-MG, although in retrospect ocular MG with functional overlay was challenging to exclude. Sensitivity of F-CBA was significantly higher than RIPA (76.7% vs. 72.7%, P = 0.002). Overall, 20/97 (21%) otherwise seronegative MG (SNMG) patients after RIPA evaluation had anti-AChR detected by F-CBA.CONCLUSIONS:
In our study anti-AChR F-CBA and RIPA both had excellent specificity, while F-CBA had 4% higher sensitivity for MG and detected anti-AChR in 21% of SNMG patients. Our findings indicate that F-CBA is a viable alternative to RIPA for anti-AChR detection. Prospective studies comparing F-CBA, RIPA and L-CBA are needed to determine optimal anti-AChR testing algorithms in MG.Palabras clave
Texto completo:
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Bases de datos:
MEDLINE
Asunto principal:
Autoanticuerpos
/
Receptores Colinérgicos
/
Miastenia Gravis
Tipo de estudio:
Diagnostic_studies
/
Observational_studies
Límite:
Female
/
Humans
Idioma:
En
Revista:
J Neurol Sci
Año:
2022
Tipo del documento:
Article
País de afiliación:
Canadá