Paraneoplastic neurological syndromes (PNS) are immune-mediated neurological disorders that can affect any part of the nervous system, occur in association with cancer and are often supported by the presence of specific neuronal autoantibodies.
Neuronal autoantibodies are classified as high-, intermediate-, or low-risk for paraneoplastic aetiology. High-risk antibodies have a >70% cancer association, recognise intracellular antigens and are not directly pathogenic. The associated tumour type depends on patient demographics and on the specific neuronal autoantibody identified.
Antibodies against amphiphysin (a 128 kDa protein associated with synaptic vesicles) are markers of autoimmune neuronal diseases such as polyradiculoneuropathy, sensory neuropathy, encephalomyelitis and Stiff-person syndrome. Their association with small-cell lung carcinoma (SCLC) and breast cancer is ~80%. They may occur alongside other autoantibodies.
Testing is recommended in patients with a recent subacute onset of neurological symptoms where a paraneoplastic basis is suspected, particularly in those with a personal history, risk factors, or family history of cancer.
For high-risk PNS, autoantibody testing should be performed using at least two independent methods.
Serum, EDTA plasma, heparin plasma, citrate plasma, CSF
Immunoblot
Fasting for at least 8-12 hours before sampling
Refer to the Health Service Charter to check storage conditions
+2/+8°C
This test provides the quantitative determination of total tau protein to support the diagnosis of Alzheimer’s disease.
This test provides the quantitative determination of tau protein phosphorylated at threonine 181 (pTau181), to support the diagnosis of Alzheimer’s disease.
Test for the determination of human autoantibodies against NMDAR to support the diagnosis of paraneoplastic neurological syndromes with an intermediate-risk phenotype.
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