Autoantibody profiles and neurological correlations of thymoma

Steven Vernino, Vanda A Lennon

Research output: Contribution to journalArticle

136 Citations (Scopus)

Abstract

Purpose: Determine muscle and neuronal autoantibody frequencies in patients with thymoma, with and without paraneoplastic neurological accompaniments. Experimental Design: Analysis of IgG autoantibodies in stored serum collected between 1985 and 2003 from 201 patients with histologically diagnosed thymoma (including six with thymic carcinoma). Contemporary assays quantitated antibodies reactive with muscle and neuronal cation channels, muscle sarcomeric proteins and neuronal cytoplasmic, and nuclear proteins. Results: Neurological diagnoses included myasthenia gravis (MG), myositis, encephalitis, neuromuscular hyperexcitability, autonomic neuropathy, and subacute hearing loss, a previously unrecognized accompaniment of thymoma. Muscle acetylcholine receptor (AChR) binding antibodies were found in all patients with a diagnosis of MG. Muscle autoantibodies (AChR-binding, AChR-modulating, or striational) were also found in 59% of patients without any neurological disorder. One or more neuronal autoantibodies were found in 41% of patients without any neurological disorder, 43% of patients with MG only, and 78% of patients with other neurological disorders. Neuronal autoantibody specificities were, in descending order of frequency, as follows: glutamic acid decarboxylase, voltage-gated potassium channel, collapsin response-mediator protein-5, ganglionic AChR, and antineuronal nuclear antibody-type 1 (ANNA-1). Conclusions: Neuronal autoantibodies complement skeletal muscle autoantibodies as serological markers of thymoma in patients with and without clinical evidence of a neurological disorder. The high prevalence of glutamic acid decarboxylase autoantibody, not previously considered a paraneoplastic marker, justifies its consideration as a marker of thymoma-related neurological autoimmunity. Serological evaluation of a patient's profile of neuronal and muscle autoantibodies may aid in preoperative identification of an indeterminate mediastinal mass.

Original languageEnglish (US)
Pages (from-to)7270-7275
Number of pages6
JournalClinical Cancer Research
Volume10
Issue number21
DOIs
StatePublished - Nov 1 2004

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Thymoma
Autoantibodies
Cholinergic Receptors
Nervous System Diseases
Myasthenia Gravis
Muscles
Glutamate Decarboxylase
Antibodies
Semaphorin-3A
Voltage-Gated Potassium Channels
Myositis
Muscle Proteins
Encephalitis
Nuclear Proteins
Autoimmunity
Hearing Loss
Cations
Skeletal Muscle
Research Design
Immunoglobulin G

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Autoantibody profiles and neurological correlations of thymoma. / Vernino, Steven; Lennon, Vanda A.

In: Clinical Cancer Research, Vol. 10, No. 21, 01.11.2004, p. 7270-7275.

Research output: Contribution to journalArticle

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abstract = "Purpose: Determine muscle and neuronal autoantibody frequencies in patients with thymoma, with and without paraneoplastic neurological accompaniments. Experimental Design: Analysis of IgG autoantibodies in stored serum collected between 1985 and 2003 from 201 patients with histologically diagnosed thymoma (including six with thymic carcinoma). Contemporary assays quantitated antibodies reactive with muscle and neuronal cation channels, muscle sarcomeric proteins and neuronal cytoplasmic, and nuclear proteins. Results: Neurological diagnoses included myasthenia gravis (MG), myositis, encephalitis, neuromuscular hyperexcitability, autonomic neuropathy, and subacute hearing loss, a previously unrecognized accompaniment of thymoma. Muscle acetylcholine receptor (AChR) binding antibodies were found in all patients with a diagnosis of MG. Muscle autoantibodies (AChR-binding, AChR-modulating, or striational) were also found in 59{\%} of patients without any neurological disorder. One or more neuronal autoantibodies were found in 41{\%} of patients without any neurological disorder, 43{\%} of patients with MG only, and 78{\%} of patients with other neurological disorders. Neuronal autoantibody specificities were, in descending order of frequency, as follows: glutamic acid decarboxylase, voltage-gated potassium channel, collapsin response-mediator protein-5, ganglionic AChR, and antineuronal nuclear antibody-type 1 (ANNA-1). Conclusions: Neuronal autoantibodies complement skeletal muscle autoantibodies as serological markers of thymoma in patients with and without clinical evidence of a neurological disorder. The high prevalence of glutamic acid decarboxylase autoantibody, not previously considered a paraneoplastic marker, justifies its consideration as a marker of thymoma-related neurological autoimmunity. Serological evaluation of a patient's profile of neuronal and muscle autoantibodies may aid in preoperative identification of an indeterminate mediastinal mass.",
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