A comparison of NMDAR-antibody detection methods
N-Methyl-D-Aspartate receptor antibody (NMDAR-ab) encephalitis is the most common antibody-mediated encephalitis. We compared four NMDAR-Ab assay methods: 1) live (a, L-CBA) or fixed (b, F-CBA) cell-based assays (CBA); 2) immunohistochemistry (IHC); 3) a commercially available CBA (C-CBA, Euroimmun...
Main Authors: | , , , , , |
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Format: | Conference item |
Language: | English |
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BMJ Publishing Group
2017
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author | Thouin, A Gastaldi, M Woodhall, M Jacobson, L Irani, S Vincent, A |
author_facet | Thouin, A Gastaldi, M Woodhall, M Jacobson, L Irani, S Vincent, A |
author_sort | Thouin, A |
collection | OXFORD |
description | N-Methyl-D-Aspartate receptor antibody (NMDAR-ab) encephalitis is the most common antibody-mediated encephalitis. We compared four NMDAR-Ab assay methods: 1) live (a, L-CBA) or fixed (b, F-CBA) cell-based assays (CBA); 2) immunohistochemistry (IHC); 3) a commercially available CBA (C-CBA, Euroimmun AG).
180 sera and 48 CSFs were tested. Sera previously positive by the Oxford L-CBA but with unlikely phenotypes were intentionally over-represented. The results of the four assays agreed in only 55.6% of sera and 82% of CSFs. C-CBA was least likely to agree with other methods (37.7% in serum). Diagnosis was available, so far, for 54 patients (NMDAR ab-encephalitis ‘definite’ in 34, ‘unlikely’ in 20). In serum, L-CBA detected NMDAR-abs in 88% of ‘definite’ patients, but had a high false-positive rate (consistent with the biased selection). IHC was negative in all unlikely patients, but positive in only 73.5% ‘definite’ patients. F-CBA and C-CBA had intermediate performances.
There was a worrying lack of concordance between tests. Assay results should be interpreted in the light of clinical information and a combination of L-CBA and IHC may give the most useful results. Further clinical information is being made available in order to increase the serum numbers and determine assay performance using CSF alone. |
first_indexed | 2024-03-06T18:45:37Z |
format | Conference item |
id | oxford-uuid:0e67b295-a433-4471-9c10-58d53fc0457d |
institution | University of Oxford |
language | English |
last_indexed | 2024-03-06T18:45:37Z |
publishDate | 2017 |
publisher | BMJ Publishing Group |
record_format | dspace |
spelling | oxford-uuid:0e67b295-a433-4471-9c10-58d53fc0457d2022-03-26T09:45:49ZA comparison of NMDAR-antibody detection methodsConference itemhttp://purl.org/coar/resource_type/c_c94fuuid:0e67b295-a433-4471-9c10-58d53fc0457dEnglishSymplectic ElementsBMJ Publishing Group2017Thouin, AGastaldi, MWoodhall, MJacobson, LIrani, SVincent, AN-Methyl-D-Aspartate receptor antibody (NMDAR-ab) encephalitis is the most common antibody-mediated encephalitis. We compared four NMDAR-Ab assay methods: 1) live (a, L-CBA) or fixed (b, F-CBA) cell-based assays (CBA); 2) immunohistochemistry (IHC); 3) a commercially available CBA (C-CBA, Euroimmun AG). 180 sera and 48 CSFs were tested. Sera previously positive by the Oxford L-CBA but with unlikely phenotypes were intentionally over-represented. The results of the four assays agreed in only 55.6% of sera and 82% of CSFs. C-CBA was least likely to agree with other methods (37.7% in serum). Diagnosis was available, so far, for 54 patients (NMDAR ab-encephalitis ‘definite’ in 34, ‘unlikely’ in 20). In serum, L-CBA detected NMDAR-abs in 88% of ‘definite’ patients, but had a high false-positive rate (consistent with the biased selection). IHC was negative in all unlikely patients, but positive in only 73.5% ‘definite’ patients. F-CBA and C-CBA had intermediate performances. There was a worrying lack of concordance between tests. Assay results should be interpreted in the light of clinical information and a combination of L-CBA and IHC may give the most useful results. Further clinical information is being made available in order to increase the serum numbers and determine assay performance using CSF alone. |
spellingShingle | Thouin, A Gastaldi, M Woodhall, M Jacobson, L Irani, S Vincent, A A comparison of NMDAR-antibody detection methods |
title | A comparison of NMDAR-antibody detection methods |
title_full | A comparison of NMDAR-antibody detection methods |
title_fullStr | A comparison of NMDAR-antibody detection methods |
title_full_unstemmed | A comparison of NMDAR-antibody detection methods |
title_short | A comparison of NMDAR-antibody detection methods |
title_sort | comparison of nmdar antibody detection methods |
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