INDIVIDUAL TEST 790
Ma (Ma-2/Ta) Antibodies (IgG)
Indication
Suspicion of paraneoplastic syndrome
Sample material
Serum
- Minim. volume: 0,5 mL
CSF
- Minim. volume: 2,0 mL
Transport
Within Sweden
- room temperature
International
- cold
Method
Immunoblot/Indirect immunofluorescence (IIF)
According to Updated Diagnostic Criteria for Paraneoplastic Neurologic Syndromes, anti-neuronal antibodies should be detected by at least two independent methods to be reliable. At Wieslab IIF and immunoblot are used.
Reference interval
Serum
- Immunoblot: ≤5 negative
- Indirect Immunofluorescence: <1:10 negative
Likvor
- Immunoblot: negative
- Indirect immunofluorescence: negative
Result
Serum
- Immunoblot: results are reported as negative, borderline, or positive with an intensity value.
- Indirect immunofluorescence (IIF): results are reported as negative or positive. Positive results will be titrated.
CSF
- Immunoblot: results are reported as negative, borderline, or positive.
- Indirect immunofluorescence (IIF): results are reported as negative or positive.
Interpretation
Ma antigen is available in two variants: Ma-1 and Ma-2. In the past, anti-Ma-1 antibodies have also been reported as a separate analysis, but studies have shown that it is antibodies against Ma-2 that are relevant for the paraneoplastic neurological syndrome. Ma-2 is also referred to as Ta. Occurrence is associated with paraneoplastic cerebellar degeneration, limbic encephalitis, and brain stem encephalitis. These antibodies can occur in many different forms of cancer, such as breast cancer, testis cancer, and small-cell lung cancer. Neurological symptoms can precede cancer diagnosis by up to 5 years.
Antibodies against Ma are graded as High-risk antibodies with a frequency of >75% of underlying cancer and a positive result yield 3 points PNS score, according to Updated Diagnostic Criteria for Paraneoplastic Neurologic Syndromes.
References
- Rosenfeld MR, Dalmau J. Neurol Clin. 2018. Paraneoplastic Neurologic Syndromes. PMID: 30072076
- Balint B et al. Brain. 2018. Movement disorders with neuronal antibodies: syndromic approach, genetic parallels and pathophysiology. PMID: 29053777
- Graus F et al. Neurol Neuroimmunol Neuroinflamm. 2021. Updated Diagnostic Criteria for Paraneoplastic Neurologic Syndromes. PMID: 34006622
- Garza M, Piquet AL. Front Neurol. 2021. Update in Autoimmune Movement Disorders: Newly Described Antigen Targets in Autoimmune and Paraneoplastic Cerebellar Ataxia. PMID: 34489848
Last updated: 2024-10-21
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ENSKILD ANALYS 790
Ma (Ma-2/Ta)-antikroppar (IgG)
Indikation
Misstanke om paraneoplastiskt syndrom
Provmaterial
Serum
- Minim. volym: 0,5 mL
Likvor
- Minim. volym: 2,0 mL
Transport
Inom Sverige
- rumstemperatur
Internationellt
- kylt
Metod
Immunoblot/Indirekt immunofluorescens (IIF)
Enligt Updated Diagnostic Criteria for Paraneoplastic Neurologic Syndromes ska anti-neuronala antikroppar detekteras med minst två oberoende metoder för att anses tillförlitliga. På Wieslab används IIF och immunoblot.
Referensintervall
Serum
- Immunoblot: ≤5 negativt
- Indirekt Immunofluorescens: <1:10 negativt
Likvor
- Immunoblot: negativt
- Indirekt immunofluorescens: negativt
Resultat
Serum
- Immunoblot: resultat anges som negativt, gränsvärde eller positivt med intensitetsvärde.
- Indirekt immunofluorescens: resultat anges som negativt eller positivt. Positivt resultat titreras.
Likvor
- Immunoblot: resultat anges som negativt, gränsvärde eller positivt.
- Indirekt immunofluorescens: resultat anges som negativt eller positivt.
Tolkning
Ma antigenet finns i två olika varianter: Ma-1 och Ma-2. Tidigare har även anti-Ma-1 antikroppar svarats ut som separat analys, men studier har visat att det är antikroppar mot Ma-2 som är relevant vid paraneoplastiska neurologiska syndrom. Ma-2 benämns även som Ta. Förekomst är associerat med paraneoplastisk cerebellär degeneration, limbisk encefalit och hjärnstamsencefalit. De kan förekomma vid många olika cancerformer, t. ex. bröstcancer, testiscancer, och småcellig lungcancer. Neurologiska symtom kan föregå cancerdiagnos med upp till 5 år.
Antikropparna riktade mot Ma bedöms vara High-risk antibodies med en förekomst på >75% för en underliggande cancer och positivitet ger 3 poäng i PNS score enligt Updated Diagnostic Criteria for Paraneoplastic Neurologic Syndromes.
Referenser
- Rosenfeld MR, Dalmau J. Neurol Clin. 2018. Paraneoplastic Neurologic Syndromes. PMID: 30072076
- Balint B et al. Brain. 2018. Movement disorders with neuronal antibodies: syndromic approach, genetic parallels and pathophysiology. PMID: 29053777
- Graus F et al. Neurol Neuroimmunol Neuroinflamm. 2021. Updated Diagnostic Criteria for Paraneoplastic Neurologic Syndromes. PMID: 34006622
- Garza M, Piquet AL. Front Neurol. 2021. Update in Autoimmune Movement Disorders: Newly Described Antigen Targets in Autoimmune and Paraneoplastic Cerebellar Ataxia. PMID: 34489848
Senast uppdaterat: 2024-10-21
Mer information
Detta är en ackrediterad analys.> Läs mer [.pdf]
Mer information om provtagning.
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