Vial

INDIVIDUAL TEST 870

CV2/CRMP5 antibodies

Indication Suspicion of paraneoplastic syndrome and autoimmune encephalitis. 

Method Immunoblot and indirect immunofluorescence (IIF).  

According to guidelines, anti-neuronal antibodies should be detected by at least two independent methods. At Wieslab, IIF and immunoblot are used. According to European guidelines, a positive result should be obtained with both methods to be reliable. 

Result Serum: The result is reported as negative, borderline or positive with a IIF titer and blot intensity. 

CSF: The result is reported as negative, borderline or positive 

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

Antibodies against CV2/CRMP5 are graded as High-risk antibodies with frequency of >80% of underlying cancer and a positive result yield 3 points PNS score, according to Updated Diagnostic Criteria for Paraneoplastic Neurologic Syndromes. 

References 
  • Lancaster E, Martinez-Hernandez E, Dalmau J. Encephalitis and antibodies to synaptic and neuronal cell surface proteins. Neurology. 2011 Jul 12;77(2):179-89. PMID: 21747075 
  • Balint B, Vincent A, Meinck HM, Irani SR, Bhatia KP. Movement disorders with neuronal antibodies: syndromic approach, genetic parallels and pathophysiology. Brain. 2018 Jan 1;141(1):13-36. PMID: 29053777 
  • Yan J et al. Anti-CV2/CRMP5 antibody-positive paraneoplastic neurological syndromes with chronic intestinal pseudo-obstruction in a small-cell lung cancer patient: a case report and literature review. J Int Med Res. 2020 Dec;48(12):300060520974466. PMID: 33305627 
  • Graus F, et al. Updated Diagnostic Criteria for Paraneoplastic Neurologic Syndromes. Neurol Neuroimmunol Neuroinflamm. 2021 May 18;8(4):e1014. PMID: 34006622 

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Neurology

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Vial

ENSKILD ANALYS 870

CV2/CRMP5-antikroppar

Indikation Misstanke om paraneoplastiska syndrom och autoimmun encefalit. 

Metod Immunoblot samt indirekt immunofluorescens (IIF).  

Enligt riktlinjer ska anti-neuronala antikroppar detekteras med minst två oberoende metoder. På Wieslab används IIF och immunoblot. Enligt europeiska riktlinjer ska positivt resultat uppnås med båda metoderna för att vara tillförlitligt. 

Svar Serum: Resultatet anges som negativt, gränsvärde eller positivt med IIF titer och blot intensitet. 

Likvor: Resultatet anges som negativt, gränsvärde eller positivt. 

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

Antikropparna riktade mot CV2/CRMP5 bedöms vara High-risk antibodies med en förekomst på > 80% för en underliggande cancer och positivitet ger 3 poäng i PNS score enligt Updated Diagnostic Criteria for Paraneoplastic Neurologic Syndromes. 

Referenser 
  • Lancaster E, Martinez-Hernandez E, Dalmau J. Encephalitis and antibodies to synaptic and neuronal cell surface proteins. Neurology. 2011 Jul 12;77(2):179-89. PMID: 21747075 
  • Balint B, Vincent A, Meinck HM, Irani SR, Bhatia KP. Movement disorders with neuronal antibodies: syndromic approach, genetic parallels and pathophysiology. Brain. 2018 Jan 1;141(1):13-36. PMID: 29053777 
  • Yan J et al. Anti-CV2/CRMP5 antibody-positive paraneoplastic neurological syndromes with chronic intestinal pseudo-obstruction in a small-cell lung cancer patient: a case report and literature review. J Int Med Res. 2020 Dec;48(12):300060520974466. PMID: 33305627 
  • Graus F, et al. Updated Diagnostic Criteria for Paraneoplastic Neurologic Syndromes. Neurol Neuroimmunol Neuroinflamm. 2021 May 18;8(4):e1014. PMID: 34006622

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