INDIVIDUAL TEST 989

Hypocretin/Orexin

IndicationSuspected narcolepsy.MethodRIAResponseQuantitative analysis of cerebrospinal fluid where the detection limit is 10 pg/ml.InterpretationHypocretin-1 levels are usually significantly reduced in individuals that have narcolepsy with cataplexy. The reason for the low hopycretin-1 levels is believed to be due to hypocretin-1-producing cells are destroyed by an immune reaction. In a study where 26 patients had narcolepsy with cataplexy, the hypocretin-1 levels were below 110 pg/ml in 23 patients. Out of the 26 patients, 15 patients had hypocretin-1 levels below the detection limit (10 pg/ml). In the study, hypocretin-1 levels in 88 patients with other neurological symptoms were 572.4 pg/ml (SD 268.5 pg/ml) compared to  363.2 pg/ml (range of 224-653 pg/ml) in the general population (determined from 47 healthy individuals).
Hypocretin-1 levels, together with the HLA genetic marker HLA-DQB1 * 0602 a very strong indication of narcolepsy with cataplexy, since over 90% of individuals with narcolepsy with cataplexy carry HLA-DQB1 * 0602.

ReferenceDauvilliers Y1, Baumann CR, Carlander B, Bischof M, Blatter T, Lecendreux M, Maly F, Besset A, Touchon J, Billiard M, Tafti M, Bassetti CL. CSF hypocretin-1 levels in narcolepsy, Kleine-Levin syndrome, and other hypersomnias and neurological conditions. J Neurol Neurosurg Psychiatry. 2003 Dec, 74 (12) :1667-73. PMID: 14638887

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Neurology

ENSKILD ANALYS 989

Hypocretin/Orexin

IndikationAnalys av hypokretin-1 (orexin A) nivåer i likvor vid misstanke om narkolepsi.MetodRIASvarKvantitativ analys i likvor där detektionsgränsen är 10 pg/ml.TolkningHypokretin-1 nivåer är vanligen kraftigt sänkta hos individer narkolepsi med kataplexi och tros bero på att de hypokretin-1-producerande cellerna förstörs. I en studie av 26 patienter med narkolepsi hade 23 patienter hypokretin-1-nivåer under 110 pg/ml varav 15 patienter hade hypokretin-1-nivåer  under detektionsgränsen.  Hypokretin-1-nivåerna var 572,4 pg/ml (SD 268,5 pg/ml) hos 88 patienter med andra neurologiska symptom och hypokretin-1-nivåerna i Csv hos normalpopulationen (bestämt från 47 friska individer) är 363,2 pg/ml med ett intervall på 224-653 pg/ml. Hypokretin-1-nivåerna ger tillsammans med den genetiska HLA markören HLA-DQB1*0602 en mycket stark indikation på narkolepsi med kataplexi eftersom att över 90% av individerna med narkolepsi med kataplexi bär på HLA-DQB1*0602. 

ReferenserDauvilliers Y1, Baumann CR, Carlander B, Bischof M, Blatter T, Lecendreux M, Maly F, Besset A, Touchon J, Billiard M, Tafti M, Bassetti CL. CSF hypocretin-1 levels in narcolepsy, Kleine-Levin syndrome, and other hypersomnias and neurological conditions. J Neurol Neurosurg Psychiatry. 2003 Dec;74(12):1667-73. PMID: 14638887     

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