What is it about?
Many patients with neurological symptoms have one or more positive neuronal autoantibodies on the commercially available paraneoplastic panels, however, in many patients the positive antibody is not the cause of the patient's symptoms. The aim of this study was to develop a clinical scale to predict clinical relevance of positive paraneoplastic panels in patients presenting with new neurological symptoms.
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Why is it important?
The recent advances in clinical neuroimmunology have led to a surge in paraneoplastic panel testing with an increased number of positive results including clinically irrelevant ones. This added a new clinical dilemma to practicing neurologists. Developing a clinical tool to differentiate clinically meaningful antibodies from non-meaningful ones can contribute significantly to clinical decision making when dealing with such patients.
Perspectives
We propose the Neuronal Autoantibody Confidence Scale. A score of 2 or more on the scale supports a clinically-relevant antibody, a score at or below 0 suggests a clinically irrelevant antibody, while a score of 1 is undetermined. Patients get 1 positive point for each of the following factors: antibodies against intracellular antigens or VGKC, smoking or cancer history, presentation with a new movement disorder, inflammatory CSF, and concomitant hyponatremia. They get one negative point if disease course was chronic.
Dr Hesham Abboud
Cleveland Clinic Lerner College of Medicine of Case Western Reserve University
Read the Original
This page is a summary of: Neuronal autoantibodies: differentiating clinically relevant and clinically irrelevant results, Journal of Neurology, October 2017, Springer Science + Business Media,
DOI: 10.1007/s00415-017-8627-4.
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