Vial

INDIVIDUAL TEST 870

CV2/CRMP5 Antibodies  (IgG)

Indication

Suspicion of paraneoplastic syndrome and autoimmune encephalitis

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

Antibodies against CV2/CRMP5 is a paraneoplastic marker that is primarily associated with small cell lung cancer (SCLC) but also occurs with thymoma and other tumor types. Clinical symptoms may be chorea, sensorimotor neuropathy, limbic encephalitis, and cerebellar degeneration. Neurological symptoms can precede cancer diagnosis by up to 5 years.

Antibodies against CV2/CRMP5 are graded as High-risk antibodies with a frequency of >80% of underlying cancer and a positive result yields a 3-point 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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Vial

ENSKILD ANALYS 870

CV2/CRMP-5-antikroppar (IgG)

Indikation

Misstanke om paraneoplastiskt syndrom och autoimmun encefalit

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

Antikroppar mot CV2/CRMP5 är en paraneoplastisk markör som framförallt är associerad med småcellig lungcancer (SCLC), men förekommer också vid thymom och andra tumörtyper. Kliniska symptom kan vara chorea, sensomotorisk neuropati, limbisk encefalit och cerebellär degeneration. Neurologiska symtom kan föregå cancerdiagnos med upp till 5 år.

Antikroppar mot CV2/CRMP5 bedöms vara High-risk antibodies med förekomst på > 80% 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

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> Läs mer [.pdf]

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