ArticleJournal of neurology2017
Neuronal autoantibodies: differentiating clinically relevant and clinically irrelevant results.
Article in Journal of neurology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
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Who cites it
19 citing papers in PubMed.
- Utility of the APEAnnals of clinical and translational neurology · 2026Article
- Alternative diagnoses in patients referred to neuroimmunology for autoimmune encephalitis evaluation.Journal of neurology · 2026Article
- Neuronal surface autoantibodies at cerebellar and brainstem synapses: mechanisms, phenotypes, and translational gaps.Frontiers in immunology · 2026Review
- Commercial immunoassays in paraneoplastic neurological syndromes: an Australian laboratory perspective.Frontiers in neurology · 2025Article
- Mimickers of autoimmune encephalitis: a literature review.The Journal of international medical research · 2024Review
- Clinical Impact of Pre-Existing Autoantibodies in Patients With SCLC Treated With Immune Checkpoint Inhibitor: A Multicenter Prospective Observational Study.JTO clinical and research reports · 2023Article
- Simulations of active zone structure and function at mammalian NMJs predict that loss of calcium channels alone is not sufficient to replicate LEMS effects.Journal of neurophysiology · 2023Article
- S100A6 participates in initiation of autoimmune encephalitis and is under epigenetic control.Brain and behavior · 2023Article
- An update on malignant tumor-related stiff person syndrome spectrum disorders: clinical mechanism, treatment, and outcomes.Frontiers in neurology · 2023Review
- Dilated fixed pupils and respiratory failure: a rare clinical course of Lambert-Eaton myasthenic syndrome.BMJ neurology open · 2023Article
- A case of repeated focal motor seizures as expression of an inflammatory cerebral process with suspected dysimmune etiology.Epilepsy & behavior reports · 2022Article
- Autoimmune encephalitis: proposed best practice recommendations for diagnosis and acute management.Journal of neurology, neurosurgery, and psychiatry · 2021Review
- Influence of Autoimmune Antibody Testing on the Use of Immunotherapy on an Inpatient Neurology Service.The Neurohospitalist · 2021Article
- Autoimmune encephalitis: proposed recommendations for symptomatic and long-term management.Journal of neurology, neurosurgery, and psychiatry · 2021Review
- The Diagnostic Value of Onconeural Antibodies Depends on How They Are Tested.Frontiers in immunology · 2020Article
- Presence of onconeural antibodies in sarcoidosis patients with parasarcoidosis syndrome.Sarcoidosis, vasculitis, and diffuse lung diseases : official journal of WASOG · 2019Article
- Low specificity of voltage-gated calcium channel antibodies in Lambert-Eaton myasthenic syndrome: a call for caution.Journal of neurology · 2018Article
- The Role of Cannabis within an Emerging Perspective on Schizophrenia.Medicines (Basel, Switzerland) · 2018Article
- Systematic Review: Syndromes, Early Diagnosis, and Treatment in Autoimmune Encephalitis.Frontiers in neurology · 2018Review
Corrections and comments
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The aim of this study is to compare the rates of clinically relevant and clinically irrelevant neuronal autoantibodies among patients presenting with new neurological symptoms. We reviewed 401 neurological patients who were tested for the Mayo-Clinic paraneoplastic panel from January 2014 to December 2014 at the Johns Hopkins Hospital. We divided antibody-positive patients into two groups: clinically relevant (CR), in which a recognizable autoimmune or paraneoplastic syndrome was confirmed, and clinically irrelevant (CI), in which an autoimmune/paraneoplastic etiology was initially suspected but an alternative diagnosis was eventually found. We used Fisher's exact test for categorical variables and Mann-Whitney U test for continuous variables to identify differences between the two groups. Fifty-three patients tested positive for one or more neuronal autoantibodies. There were 17 CR (65% females, mean age 56 years), 33 CI, and 3 indeterminate patients. Compared to CI patients, CR patients were more likely to present with movement disorders or stiff person syndrome, have inflammatory CSF markers, cancer or smoking history, concomitant hyponatremia, and classical onconeuronal antibodies. CI patients were more likely to have a neuromuscular presentation, a chronic course, and antibodies against synaptic antigens. By combining the most robust differentiating factors, we developed a simple scale that predicted clinical relevance with an odds ratio of 50.3 (CI 8.2-309.9, P < 0.0001) if the score was ≥ 2. Up to 62% of neuronal autoantibody-positive patients are ultimately found to have an alternative diagnosis. Several clinical and laboratory factors can differentiate CR from CI patients to aid in interpretation of positive results.
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