INDIVIDUAL TEST 546
Ganglioside Antibodies (IgG, IgM)
Indication
Suspicion of Inflammatory neuropathy.
Method
ELISA detecting IgG and IgM antibodies against recombinant antigen GM1, GT1a, GD1a, GD1b, GQ1b.
Result
Results are reported as negative, borderline, or positive with a value as % (serum) or as a ratio (CSF).
Reference interval:
Serum
- Negative: < 30%
- Borderline: 30-50% Borderline result has uncertain clinical relevance
- Positive: > 50-100%
- Strong positive: > 100%
CSF
- Negative < 10
- Borderline < 15 Borderline result has uncertain clinical relevance
- Positive ≥ 15
Interpretation
Gangliosides are a group of glycosphingolipids which are enriched neuronal plasma membranes and are involved in signal transduction. Antibodies against many different types of gangliosides are associated with sensor and motor neuropathies. Antibodies against multiple gangliosides can often be detected simultaneously due to cross-reactivity as result of their high molecular similarity. Low levels of antibodies against gangliosides may occur without disease association and may be transiently seen after infections.
References
Willison HJ, Yuki N. Peripheral neuropathies and anti-glycolipid antibodies. Brain. 2002 Dec;125(Pt 12):2591-625. PMID: 12429589.
Nobile-Orazio E et al. How useful are anti-neural IgM antibodies in the diagnosis of chronic immune-mediated neuropathies? J Neurol Sci. 2008 Mar 15;266(1-2):156-63. PMID: 17915254.
Kuijf ML et al. Detection of anti-MAG antibodies in polyneuropathy associated with IgM monoclonal gammopathy. Neurology. 2009 Sep 1;73(9):688-95. PMID: 19720975.
Renaud S et al. High-dose rituximab and anti-MAG-associated polyneuropathy. Neurology. 2006 Mar 14;66(5):742-4. PMID: 16534115.
Benedetti L et al. Predictors of response to rituximab in patients with neuropathy and anti-myelin associated glycoprotein immunoglobulin M. J Peripher Nerv Syst. 2007 Jun;12(2):102-7. PMID: 17565535.
Benedetti L et al. Long-term effect of rituximab in anti-mag polyneuropathy. Neurology. 2008 Nov 18;71(21):1742-4. PMID: 19015493.
Jacobs BC et al; IGOS Consortium. International Guillain-Barré Syndrome Outcome Study: protocol of a prospective observational cohort study on clinical and biological predictors of disease course and outcome in Guillain-Barré syndrome. J Peripher Nerv Syst. 2017 Jun;22(2):68-76. PMID: 28406555.
Shang P et al. Axonal variants of Guillain-Barré syndrome: an update. J Neurol. 2021 Jul;268(7):2402-2419. PMID: 32140865.
Sheikh AB et al. Association of Guillain-Barre syndrome with COVID-19 infection: An updated systematic review. J Neuroimmunol. 2021 Jun 15;355:577577. PMID: 33895700.
Van den Bergh PYK et al. European Academy of Neurology/Peripheral Nerve Society guideline on diagnosis and treatment of chronic inflammatory demyelinating polyradiculoneuropathy: Report of a joint Task Force-Second revision. J Peripher Nerv Syst. 2021 Sep;26(3):242-268. doi: 10.1111/jns.12455. Epub 2021 Jul 30. Erratum in: J Peripher Nerv Syst. 2022 Mar;27(1):94. Erratum in: Eur J Neurol. 2022 Apr;29(4):1288. PMID: 34085743.
Wijdicks EF, Klein CJ. Guillain-Barré Syndrome. Mayo Clin Proc. 2017 Mar;92(3):467-479. PMID: 28259232.
Willison HJ et al. Guillain-Barré syndrome. Lancet. 2016 Aug 13;388(10045):717-27. PMID: 26948435.
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ENSKILD ANALYS 546
Gangliosider-antikroppar (IgG, IgM)
Indikation
Misstanke om Inflammatorisk neuropati.
Metod
ELISA med detektion av IgG- och IgM-antikroppar mot rekombinanta antigen för GM1, GT1a, GD1a, GD1b, GQ1b.
Resultat
Resultat anges som negativt, gränsvärde, eller positivt med värde i % (serum) eller som en kvot (likvor).
Referensintervall:
Serum
- Negativt: <30 %
- Gränsvärde: 30-50% Gränsvärde tolkas vara av tveksam klinisk betydelse
- Positivt: >50-100%
- Starkt positivt: >100%
Likvor
- Negativt <10
- Gränsvärde < 15. Gränsvärde tolkas vara av tveksam klinisk betydelse
- Positivt ≥ 15
Tolkning
Gangliosider är en grupp glykosfingolipider som är anrikade neuronala plasmamembran där de bl.a. har betydelse för signaltransduktion. Antikroppar mot många olika typer av gangliosider är associerade med motoriska och sensorimotoriska neuropatier. Antikroppar mot flera gangliosider kan ofta påvisas samtidigt vilket beror på korsreaktivitet eftersom det är stor molekylär likhet mellan olika gangliosider. Låga nivåer av antikroppar mot gangliosider kan förekomma utan koppling till sjukdom och kan ses övergående efter infektioner.
Referenser
Willison HJ, Yuki N. Peripheral neuropathies and anti-glycolipid antibodies. Brain. 2002 Dec;125(Pt 12):2591-625. PMID: 12429589.
Nobile-Orazio E et al. How useful are anti-neural IgM antibodies in the diagnosis of chronic immune-mediated neuropathies? J Neurol Sci. 2008 Mar 15;266(1-2):156-63. PMID: 17915254.
Kuijf ML et al. Detection of anti-MAG antibodies in polyneuropathy associated with IgM monoclonal gammopathy. Neurology. 2009 Sep 1;73(9):688-95. PMID: 19720975.
Renaud S et al. High-dose rituximab and anti-MAG-associated polyneuropathy. Neurology. 2006 Mar 14;66(5):742-4. PMID: 16534115.
Benedetti L et al. Predictors of response to rituximab in patients with neuropathy and anti-myelin associated glycoprotein immunoglobulin M. J Peripher Nerv Syst. 2007 Jun;12(2):102-7. PMID: 17565535.
Benedetti L et al. Long-term effect of rituximab in anti-mag polyneuropathy. Neurology. 2008 Nov 18;71(21):1742-4. PMID: 19015493.
Jacobs BC et al; IGOS Consortium. International Guillain-Barré Syndrome Outcome Study: protocol of a prospective observational cohort study on clinical and biological predictors of disease course and outcome in Guillain-Barré syndrome. J Peripher Nerv Syst. 2017 Jun;22(2):68-76. PMID: 28406555.
Shang P et al. Axonal variants of Guillain-Barré syndrome: an update. J Neurol. 2021 Jul;268(7):2402-2419. PMID: 32140865.
Sheikh AB et al. Association of Guillain-Barre syndrome with COVID-19 infection: An updated systematic review. J Neuroimmunol. 2021 Jun 15;355:577577. PMID: 33895700.
Van den Bergh PYK et al. European Academy of Neurology/Peripheral Nerve Society guideline on diagnosis and treatment of chronic inflammatory demyelinating polyradiculoneuropathy: Report of a joint Task Force-Second revision. J Peripher Nerv Syst. 2021 Sep;26(3):242-268. doi: 10.1111/jns.12455. Epub 2021 Jul 30. Erratum in: J Peripher Nerv Syst. 2022 Mar;27(1):94. Erratum in: Eur J Neurol. 2022 Apr;29(4):1288. PMID: 34085743.
Wijdicks EF, Klein CJ. Guillain-Barré Syndrome. Mayo Clin Proc. 2017 Mar;92(3):467-479. PMID: 28259232.
Willison HJ et al. Guillain-Barré syndrome. Lancet. 2016 Aug 13;388(10045):717-27. PMID: 26948435.