Conference item : Abstract
A comparison of NMDAR-antibody detection methods
- Abstract:
- 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.
- Publication status:
- Published
- Peer review status:
- Peer reviewed
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Access Document
- Files:
-
-
(Preview, Accepted manuscript, pdf, 45.8KB, Terms of use)
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- Publisher copy:
- 10.1136/jnnp-2017-ABN.183
Authors
- Publisher:
- BMJ Publishing Group
- Host title:
- Journal of Neurology, Neurosurgery and Psychiatry
- Journal:
- Journal of Neurology, Neurosurgery and Psychiatry More from this journal
- Volume:
- 88
- Issue:
- Supplement 1
- Pages:
- A53
- Article number:
- PO154
- Publication date:
- 2017-12-01
- Acceptance date:
- 2017-05-03
- Event title:
- Association of British Neurologists Annual Meeting 2017
- Event location:
- ACC, Liverpool
- Event website:
- https://jnnp.bmj.com/content/88/Suppl_1
- Event start date:
- 2017-05-03
- Event end date:
- 2017-05-05
- DOI:
- EISSN:
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1468-330X
- ISSN:
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0022-3050
- Commissioning body:
- Association of British Neurologists
- Language:
-
English
- Keywords:
- Subtype:
-
Abstract
- Pubs id:
-
1027444
- Local pid:
-
pubs:1027444
- Deposit date:
-
2020-09-21
- ARK identifier:
Terms of use
- Copyright holder:
- BMJ Publishing Group Limited
- Copyright date:
- 2017
- Rights statement:
- © 2017, Published by the BMJ Publishing Group Limited.
- Notes:
- This is the accepted manuscript version of the article. The final version is available online from BMJ Publishing Group at http://dx.doi.org/10.1136/jnnp-2017-ABN.183
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