Presenter of 1 Presentation
O002 - CLINICAL IMPLICATIONS OF MYELIN BASIC PROTEIN ANTIBODIES AND NEUROLOGICAL ANTIPHOSPHOLIPID SYNDROME (ID 366)
Abstract
Background and Aims
Anti-lipid autoimmune diseases pose a difficult differential diagnosis with relevant clinical implications. There is a need of new tissue-specific autoantibodies for a more precise diagnosis. Our objective was to determine the incidence of myelin basic protein (MBP) antibodies detected on peripheral nerve by indirect immunoflourescence (IIF) and of antiphospholipid antibodies (aPL) in the serum of neurological patients.
Methods
Sera of 77 patients with suspected central (CNS) or peripheral nervous system (PNS) disorders were tested using neurology mosaics (Euroimmun, Lubeck, Germany) with tissue sections of cerebellum, plexus myentericus and peripheral nerve. All samples were tested for serum aPL antibodies (IgG and IgM anti-cardiolipin and anti-β2-glycoprotein I) using multiplex flow analyzer (Bio-Rad Laboratories, Hercules, CA). Positive results for aPL antibodies were consider as ≥ 7 UI/mL.
Results
Twenty-seven out of 77 (35%) had positive MBP antibodies. Of these 27, 29% (n=8) had positive aPL. Among these 8 patients, 5 were women (62.5%), median age 53 years (range, 33 to 71 years old). The most predominant aPL antibody found was IgM anti-β2-glycoprotein. The values obtained (median±SD) were as follows: IgG anti-cardiolipin: 29.32±69.82; IgM anti-cardiolipin: 11.25±4.26; IgG anti-β2-glycoprotein: 103.55±80.11; IgM anti-β2-glycoprotein: 14.10±57.55. The clinical manifestations included CNS (n=16) or PNS (n=11) signs and symptoms: white matter lesions, epileptic activity, MS-like syndrome, optic neuropathy, chronic migraines and peripheral neuropathies.
Conclusions
Peripheral anti-MBP autoantibodies were present in a third of our cohort with mainly CNS manifestations, pointing to a more extensive anti-lipid reaction. A further third of them had antiphospholipid syndrome, which has relevant therapeutic consequences (thromboprophylaxis).