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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ENSKILD ANALYS 870
CV2/CRMP-5-antikroppar (IgG)
Indikation
Misstanke om paraneoplastiskt syndrom och autoimmun encefalit
Provmaterial
Serum
- Minim. volym: 0,5 mL
- 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
Detta är en ackrediterad analys.> Läs mer [.pdf]
Mer information om provtagning.
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