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25.10.2019 | Original Article | Ausgabe 2/2020

Neurological Sciences 2/2020

Anti-MAG IgM: differences in antibody tests and correlation with clinical findings

Zeitschrift:
Neurological Sciences > Ausgabe 2/2020
Autoren:
Sabrina Matà, Stefano Ambrosini, Domenica Saccomanno, Tiziana Biagioli, Marinella Carpo, Aldo Amantini, Fabio Giannini, Alessandro Barilaro, Lucia Toscani, Monica Del Mastio, Giacomo Pietro Comi, Sandro Sorbi
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Abstract

Objectives

Anti-myelin-associated glycoprotein (MAG) antibody is associated with clinically heterogeneous polyneuropathies. Our purpose was to compare neuropathy phenotypes identified by different anti-MAG tests’ results.

Methods

Cohort study: Sera from 40 neuropathy anti-MAG EIA positive patients were tested for anti-MAG by Western blot (WB), for anti-peripheral nerve myelin (PNM) on monkey nerve by immunofluorescence assay (IFA), and for anti-HNK1 on rat CNS slices by IFA. Anti-sulfatide antibodies, for comparison, were also tested by EIA.

Results

Among 40 anti-MAG EIA positive sera, 85% also had anti-PNM IFA reactivity and 67.5% bind HNK1 on rat CNS. Anti-HNK1 positive patients had the classical predominantly distal acquired demyelinating symmetric (DADS) neuropathy with a benign course, while anti-PNM positive but anti-HNK1 negative patients had predominantly axonal neuropathy with a high frequency of anti-sulfatide reactivity and the worst long-term prognosis. Anti-MAG EIA positive patients without anti-PNM or anti-HNK1 IFA reactivity had a CIDP-like polyneuropathy.

Conclusion

Different methods to test for anti-MAG antibodies identify different clinical and electrophysiological findings, as well as long-term outcome. HNK1 reactivity is the strongest marker of DADS.

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