Your browser doesn't support javascript.
loading
Antibodies in Autoimmune Neuropathies: What to Test, How to Test, Why to Test.
Pascual-Goñi, Elba; Caballero-Ávila, Marta; Querol, Luis.
Affiliation
  • Pascual-Goñi E; From the Neuromuscular Diseases Unit (E.P.-G., M.C.-Á., L.Q.), Department of Neurology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona; ERN (European Reference Network) EURO-NMD (Neuromuscular Disorders); and Centro para la Investigación Biomédica en Red en Enfermedades Raras (CIBERER) (E.P.-G., L.Q.), Madrid, Spain.
  • Caballero-Ávila M; From the Neuromuscular Diseases Unit (E.P.-G., M.C.-Á., L.Q.), Department of Neurology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona; ERN (European Reference Network) EURO-NMD (Neuromuscular Disorders); and Centro para la Investigación Biomédica en Red en Enfermedades Raras (CIBERER) (E.P.-G., L.Q.), Madrid, Spain.
  • Querol L; From the Neuromuscular Diseases Unit (E.P.-G., M.C.-Á., L.Q.), Department of Neurology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona; ERN (European Reference Network) EURO-NMD (Neuromuscular Disorders); and Centro para la Investigación Biomédica en Red en Enfermedades Raras (CIBERER) (E.P.-G., L.Q.), Madrid, Spain.
Neurology ; 103(4): e209725, 2024 Aug 27.
Article in En | MEDLINE | ID: mdl-39088795
ABSTRACT
Autoimmune neuropathies are a heterogeneous group of immune-mediated disorders of the peripheral nerves. Guillain-Barré syndrome (GBS) and chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) are the archetypal acute and chronic forms. Over the past few decades, pathogenic antibodies targeting antigens of the peripheral nervous system and driving peripheral nerve damage in selected patients have been described. Moreover, the detection of these antibodies has diagnostic and therapeutic implications that have prompted a modification of the GBS and CIDP diagnostic algorithms. GBS diagnosis is based in clinical criteria, and systematic testing of anti-ganglioside antibodies is not required. Nonetheless, a positive anti-ganglioside antibody test may support the clinical suspicion when diagnosis of GBS (GM1 IgG), Miller Fisher (GQ1b IgG), or acute sensory-ataxic (GD1b IgG) syndromes is uncertain. Anti-myelin-associated glycoprotein (MAG) IgM and anti-disialosyl IgM antibodies are key in the diagnosis of anti-MAG neuropathy and chronic ataxic neuropathy, ophthalmoplegia, M-protein, cold agglutinins, and disialosyl antibodies spectrum neuropathies, respectively, and help differentiating these conditions from CIDP. Recently, the field has been boosted by the discovery of pathogenic antibodies targeting proteins of the node of Ranvier contactin-1, contactin-associated protein 1, and nodal and paranodal isoforms of neurofascin (NF140, NF186, or NF155). These antibodies define subgroups of patients with specific clinical (most importantly poor or partial response to conventional therapies and excellent response to anti-CD20 therapy) and pathologic (node of Ranvier disruption in the absence of inflammation) features that led to the definition of the "autoimmune nodopathy" diagnostic category and to the incorporation of nodal/paranodal antibodies to clinical routine testing. The purpose of this review was to provide a practical vision for the general neurologist of the use of antibodies in the clinical assessment of autoimmune neuropathies.
Subject(s)

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Autoantibodies / Guillain-Barre Syndrome / Polyradiculoneuropathy, Chronic Inflammatory Demyelinating Limits: Humans Language: En Journal: Neurology Year: 2024 Document type: Article Affiliation country: Country of publication:

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Autoantibodies / Guillain-Barre Syndrome / Polyradiculoneuropathy, Chronic Inflammatory Demyelinating Limits: Humans Language: En Journal: Neurology Year: 2024 Document type: Article Affiliation country: Country of publication: