NEURONAL AUTOIMMUNOLOGY : AN INCREASING DIAGNOSTIC AND ASSOCIATION WITH THE DEMAND FOR OLIGOCLONAL BANDS IN LIQUOR
- Alessandra Melegari, Italy
Abstract
Background and Aims
In recent years, new autoantibodies specificities have been identified aimed at different neurological syndromes.New tests are now available for the detection of their autoantibodies, mainly in indirect immunofluorescence and immunoblot. The Laboratory of Autoimmunology is now a major element in the diagnostic pathway of patients suffering from disimmune peripheral neuropathies, demyelinizing diseases of CNS, paraneoplastic neurological syndromes and autoimmune encephalitis.
Methods
In 2018-2019, a total of 2057 tests were carried out in Modena ad Parma Autoimmunity Laboratories including: neuronal, ganglioside, AQP4, MOG, MAG, encephalitis antibodies.
Results
The positive percentages were higher for: neuronal antibodies and ganglioside antibodies respectively (18% and 35%). Autoantibody test positivity rates were very low for AQP4 and MOG (4%) and for Encephalitis research (3%). Relatively oligoclonal bands (O.B.) in CSF, support tests in infectious neurological diagnostics, cancer, inflammatory and autoimmune, we found 49/131 (37%) negative patients,35/131(27%) patients with reflex profile and 54/131 (36%) patients who are associated with MS. In terms of O.B. correlation and antibodies, patients who had positivity to different antibodies for antigens 13/88 (15%) have been largely negative for profiles MS-related CSF, except for one patient with positivity for anti-sulfatids antibodies.
Conclusions
The data shown in our study, related to the diagnostics for immuno-mediated diseases of the central and peripheral NS, indicate that there is a growing demand since these tests are proving to be of high use for clinical framing but to improve the prescriptive appropriateness, it will be necessary to improve the algorithm to be used and which matrix if serum or CSF use.