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Detection of anti-MAG antibodies in polyneuropathy associated with IgM monoclonal gammopathy.
Neurology. 2009 Sep 01; 73(9):688-95.Neur

Abstract

BACKGROUND

Detection of serum antibodies to myelin-associated glycoprotein (MAG) by Western blot (WB) is a valuable assay to diagnose a distinct type of demyelinating polyneuropathy with immunoglobulin M (IgM) monoclonal gammopathy. In this study, the diagnostic accuracy of a new and more practical ELISA to detect these antibodies was validated.

METHODS

Routine WBs from 2 independent laboratories and ELISA were used to detect anti-MAG IgM in serum from 207 patients with neuropathy and controls. The sensitivity and specificity of these assays were compared and related to the patient clinical and electrophysiologic characteristics.

RESULTS

In ELISA, anti-MAG antibodies were found in serum from 49 (72%) of 68 patients with demyelinating polyneuropathy and IgM monoclonal gammopathy. However, in this subgroup of patients, only 30 (44%) and 37 (54%) were positive in the 2 WBs. All of the patients positive in the 2 WBs were also positive in ELISA. A high correlation was found for IgM activity in ELISA to MAG and sulfate-3-glucuronyl paragloboside (SGPG) (Spearman rho = 0.72, p < 0.0001), supporting the notion that the shared sulfated glucuronic acid moiety of MAG and SGPG is preserved. Most patients positive in anti-MAG ELISA had a slowly progressive sensory-motor demyelinating polyneuropathy, even if the WB was negative. In control groups, however, 4 WB-negative patients with a nondemyelinating monoclonal gammopathy-related polyneuropathy were positive in anti-MAG ELISA. The remaining samples were negative in ELISA.

CONCLUSION

ELISA is more sensitive than Western blot to diagnose anti-myelin-associated glycoprotein related polyneuropathy, although a positive serology may be found in other forms of polyneuropathy as well.

Authors+Show Affiliations

Erasmus MC, s'-Gravendijkwal 230, 3015 CE Rotterdam, The Netherlands. m.kuijf@erasmusmc.nlNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19720975

Citation

Kuijf, M L., et al. "Detection of anti-MAG Antibodies in Polyneuropathy Associated With IgM Monoclonal Gammopathy." Neurology, vol. 73, no. 9, 2009, pp. 688-95.
Kuijf ML, Eurelings M, Tio-Gillen AP, et al. Detection of anti-MAG antibodies in polyneuropathy associated with IgM monoclonal gammopathy. Neurology. 2009;73(9):688-95.
Kuijf, M. L., Eurelings, M., Tio-Gillen, A. P., van Doorn, P. A., van den Berg, L. H., Hooijkaas, H., Stork, J., Notermans, N. C., & Jacobs, B. C. (2009). Detection of anti-MAG antibodies in polyneuropathy associated with IgM monoclonal gammopathy. Neurology, 73(9), 688-95. https://doi.org/10.1212/WNL.0b013e3181b59a80
Kuijf ML, et al. Detection of anti-MAG Antibodies in Polyneuropathy Associated With IgM Monoclonal Gammopathy. Neurology. 2009 Sep 1;73(9):688-95. PubMed PMID: 19720975.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Detection of anti-MAG antibodies in polyneuropathy associated with IgM monoclonal gammopathy. AU - Kuijf,M L, AU - Eurelings,M, AU - Tio-Gillen,A P, AU - van Doorn,P A, AU - van den Berg,L H, AU - Hooijkaas,H, AU - Stork,J, AU - Notermans,N C, AU - Jacobs,B C, PY - 2009/9/2/entrez PY - 2009/9/2/pubmed PY - 2009/10/14/medline SP - 688 EP - 95 JF - Neurology JO - Neurology VL - 73 IS - 9 N2 - BACKGROUND: Detection of serum antibodies to myelin-associated glycoprotein (MAG) by Western blot (WB) is a valuable assay to diagnose a distinct type of demyelinating polyneuropathy with immunoglobulin M (IgM) monoclonal gammopathy. In this study, the diagnostic accuracy of a new and more practical ELISA to detect these antibodies was validated. METHODS: Routine WBs from 2 independent laboratories and ELISA were used to detect anti-MAG IgM in serum from 207 patients with neuropathy and controls. The sensitivity and specificity of these assays were compared and related to the patient clinical and electrophysiologic characteristics. RESULTS: In ELISA, anti-MAG antibodies were found in serum from 49 (72%) of 68 patients with demyelinating polyneuropathy and IgM monoclonal gammopathy. However, in this subgroup of patients, only 30 (44%) and 37 (54%) were positive in the 2 WBs. All of the patients positive in the 2 WBs were also positive in ELISA. A high correlation was found for IgM activity in ELISA to MAG and sulfate-3-glucuronyl paragloboside (SGPG) (Spearman rho = 0.72, p < 0.0001), supporting the notion that the shared sulfated glucuronic acid moiety of MAG and SGPG is preserved. Most patients positive in anti-MAG ELISA had a slowly progressive sensory-motor demyelinating polyneuropathy, even if the WB was negative. In control groups, however, 4 WB-negative patients with a nondemyelinating monoclonal gammopathy-related polyneuropathy were positive in anti-MAG ELISA. The remaining samples were negative in ELISA. CONCLUSION: ELISA is more sensitive than Western blot to diagnose anti-myelin-associated glycoprotein related polyneuropathy, although a positive serology may be found in other forms of polyneuropathy as well. SN - 1526-632X UR - https://www.unboundmedicine.com/medline/citation/19720975/Detection_of_anti_MAG_antibodies_in_polyneuropathy_associated_with_IgM_monoclonal_gammopathy_ L2 - http://www.neurology.org/cgi/pmidlookup?view=long&amp;pmid=19720975 DB - PRIME DP - Unbound Medicine ER -