INDIVIDUAL TEST 877

GABA B receptor antibodies

IndicationSuspicion of paraneoplastic syndromes particularly in autoimmune encephalitis.MethodIndirect immunofluorescence (IIF) using transfected cells.AnswerThe result is reported as positive or negative. A positive result is followed by a titer (serum).InterpretationAntibodies against GABA B receptors may occur in classical autoimmune encephalitis. There are relatively few cases published, of which 50% have been women, age when diagnosed between 24-75 years (median 62 years). The antibodies have been associated with small cell lung cancer in 50-60% of the cases. Antibodies may occur together with other autoantibodies in around 50% of the cases (antibodies against GAD-65, VGCC, and TPO).

GABA B receptors belong to the group of extracellular antigens. Generally, immunotherapy is more often effective in autoantibodies directed against extracellular antigens than in autoantibodies against intracellular antigens. Antibody titers can be used to monitor treatment effectiveness. Screening for cancer diagnosis is recommended.

ReferencesLancaster, Martinez-Hernandez, Dalmau. Encephalitis and antibodies to synaptic and neuronal cell surface proteins. Neurology. 2011 Jul 12;77(2):179-89.  PMID: 21747075

Titulaera et al. Screening for tumours in paraneoplastic syndromes: report of an EFNS Task Force. European Journal of Neurology. Epublished 2010. Eur J Neurol. 2011 January; 18(1): 19–23. PMID: 20880069.

Zuliani, Graus, Giometto, Bien, Vincent. Central nervous system neuronal surface antibody associated syndromes: review and guidelines for recognition. J Neurol Neurosurg Psychiatry 2012;83:638-645. PMID: 22448032

Lancaster, Lai, Peng, et al. Antibodies to the GABA(B) receptor in limbic encephalitis with seizures: case series and characterisation of the antigen. Lancet Neurol 2010;9:67-76. PMID 19962348.

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Neurology

ENSKILD ANALYS 877

GABA B receptor-antikroppar

IndikationMisstanke om paraneoplastiska syndrom och framför allt vid autoimmun encefalit.MetodIndirekt immunofluorescens (IIF) med transfekterade celler.Svar Resultatet anges som positiv eller negativ. Positivt resultat titreras (serum).TolkningAntikroppar mot GABA B receptor kan förekomma vid klassisk autoimmun encephalit. Det finns relativt få fall publicerade varav 50% har varit kvinnor, ålder vid diagnos mellan 24-75 år (median 62 år). Antikropparna har varit associerade med småcellig lungcancer i 50-60% av fallen. Antikropparna kan förekomma tillsammans med andra autoantikroppar i runt 50% av fallen (antikroppar mot GAD-65, VGCC, och TPO).

GABA B receptorerna räknas till gruppen extracellulära antigen. Generellt sett är behandling med immunoterapi oftare effektiv vid autoantikroppar riktade mot extracellulära antigen än vid autoantikroppar mot intracellulära antigen. Antikroppstitrar kan användas för att följa behandlingseffektivitet. Uppföljning med cancerdiagnostik rekommenderas.

ReferenserLancaster, Martinez-Hernandez, Dalmau. Encephalitis and antibodies to synaptic and neuronal cell surface proteins. Neurology. 2011 Jul 12;77(2):179-89.  PMID: 21747075

Titulaera et al. Screening for tumours in paraneoplastic syndromes: report of an EFNS Task Force. European Journal of Neurology. Epublished 2010. Eur J Neurol. 2011 January; 18(1): 19–23. PMID: 20880069.

Zuliani, Graus, Giometto, Bien, Vincent. Central nervous system neuronal surface antibody associated syndromes: review and guidelines for recognition. J Neurol Neurosurg Psychiatry 2012;83:638-645. PMID: 22448032

Lancaster, Lai, Peng, et al. Antibodies to the GABA(B) receptor in limbic encephalitis with seizures: case series and characterisation of the antigen. Lancet Neurol 2010;9:67-76. PMID 19962348.

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