Ganglionic acetylcholine receptor autoantibody

Oncological, neurological, and serological accompaniments

Research output: Contribution to journalArticle

96 Citations (Scopus)

Abstract

Objective: To describe the clinical utility of the nicotinic ganglionic acetylcholine receptor (α3-AChR) autoantibody as a marker of neurological autoimmunity and cancer. Design: Case-control study. Setting: Mayo Clinic, Rochester, Minnesota. Patients: A total of 15 000 patients seen at Mayo Clinic (2005-2007) and evaluated on a service basis for paraneoplastic neurological autoimmunity for whom clinical information was obtained retrospectively by medical record review as well as 457 neurologically asymptomatic patients or control subjects ofwhom173 were healthy, 245 had lung cancer, and 39 had systemic lupus erythematosus or Sjögren syndrome. Outcome Measures: Neurological, oncological, and serological associations of α3-AChR autoantibody seropositivity. Results: Of 15 000 patients tested on a service basis, 1% were seropositive (median, 0.12 nmol/L; range, 0.03-18.8 nmol/L; normal, ≤0.02 nmol/L), 55% were male, and the median age was 65 years. Cancer was found (new or by history) in 24 of 78 patients evaluated for cancer while at Mayo Clinic (30%); 43% had adenocarcinoma (more patients had breast cancer than prostate, lung, and gastrointestinal cancers; each of the latter groups had about the same number of patients). Of 12 patients with high antibody values (≥1.00 nmol/L), 83% had pandysautonomia. Of 85 patients with medium antibody values (0.10-0.99 nmol/L), neurological presentations were more diverse and included peripheral neuropathies (36%), dysautonomia (20%, usually limited), and encephalopathy (13%). Of 58 patients with low antibody values (0.03-0.09 nmol/L), 54% had a nonautoimmune neurological disorder or no neurological disorder. Of 245 control patients with lung cancer, 7.8% were seropositive. Only 1 of 212 control patients without cancer (0.5%) was seropositive (P<.001). Conclusion: The detection of α3-AChR autoantibody aids the diagnosis of neurological autoimmunity and cancer.

Original languageEnglish (US)
Pages (from-to)735-741
Number of pages7
JournalArchives of Neurology
Volume66
Issue number6
DOIs
StatePublished - Jun 2009

Fingerprint

Cholinergic Receptors
Autoantibodies
Lung Neoplasms
Autoimmunity
Neoplasms
Nervous System Diseases
Accompaniment
Antibodies
Prostatic Neoplasms
Primary Dysautonomias
Gastrointestinal Neoplasms
Nicotinic Receptors
Brain Diseases
Peripheral Nervous System Diseases
Systemic Lupus Erythematosus
Medical Records
Case-Control Studies
Adenocarcinoma
Cancer
History

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

@article{c5c8a33d69ca4762a57cd2eb33a199df,
title = "Ganglionic acetylcholine receptor autoantibody: Oncological, neurological, and serological accompaniments",
abstract = "Objective: To describe the clinical utility of the nicotinic ganglionic acetylcholine receptor (α3-AChR) autoantibody as a marker of neurological autoimmunity and cancer. Design: Case-control study. Setting: Mayo Clinic, Rochester, Minnesota. Patients: A total of 15 000 patients seen at Mayo Clinic (2005-2007) and evaluated on a service basis for paraneoplastic neurological autoimmunity for whom clinical information was obtained retrospectively by medical record review as well as 457 neurologically asymptomatic patients or control subjects ofwhom173 were healthy, 245 had lung cancer, and 39 had systemic lupus erythematosus or Sj{\"o}gren syndrome. Outcome Measures: Neurological, oncological, and serological associations of α3-AChR autoantibody seropositivity. Results: Of 15 000 patients tested on a service basis, 1{\%} were seropositive (median, 0.12 nmol/L; range, 0.03-18.8 nmol/L; normal, ≤0.02 nmol/L), 55{\%} were male, and the median age was 65 years. Cancer was found (new or by history) in 24 of 78 patients evaluated for cancer while at Mayo Clinic (30{\%}); 43{\%} had adenocarcinoma (more patients had breast cancer than prostate, lung, and gastrointestinal cancers; each of the latter groups had about the same number of patients). Of 12 patients with high antibody values (≥1.00 nmol/L), 83{\%} had pandysautonomia. Of 85 patients with medium antibody values (0.10-0.99 nmol/L), neurological presentations were more diverse and included peripheral neuropathies (36{\%}), dysautonomia (20{\%}, usually limited), and encephalopathy (13{\%}). Of 58 patients with low antibody values (0.03-0.09 nmol/L), 54{\%} had a nonautoimmune neurological disorder or no neurological disorder. Of 245 control patients with lung cancer, 7.8{\%} were seropositive. Only 1 of 212 control patients without cancer (0.5{\%}) was seropositive (P<.001). Conclusion: The detection of α3-AChR autoantibody aids the diagnosis of neurological autoimmunity and cancer.",
author = "McKeon, {Andrew B} and Lennon, {Vanda A} and Lachance, {Daniel H} and Fealey, {Robert D.} and Pittock, {Sean J}",
year = "2009",
month = "6",
doi = "10.1001/archneurol.2009.78",
language = "English (US)",
volume = "66",
pages = "735--741",
journal = "Archives of Neurology",
issn = "0003-9942",
publisher = "American Medical Association",
number = "6",

}

TY - JOUR

T1 - Ganglionic acetylcholine receptor autoantibody

T2 - Oncological, neurological, and serological accompaniments

AU - McKeon, Andrew B

AU - Lennon, Vanda A

AU - Lachance, Daniel H

AU - Fealey, Robert D.

AU - Pittock, Sean J

PY - 2009/6

Y1 - 2009/6

N2 - Objective: To describe the clinical utility of the nicotinic ganglionic acetylcholine receptor (α3-AChR) autoantibody as a marker of neurological autoimmunity and cancer. Design: Case-control study. Setting: Mayo Clinic, Rochester, Minnesota. Patients: A total of 15 000 patients seen at Mayo Clinic (2005-2007) and evaluated on a service basis for paraneoplastic neurological autoimmunity for whom clinical information was obtained retrospectively by medical record review as well as 457 neurologically asymptomatic patients or control subjects ofwhom173 were healthy, 245 had lung cancer, and 39 had systemic lupus erythematosus or Sjögren syndrome. Outcome Measures: Neurological, oncological, and serological associations of α3-AChR autoantibody seropositivity. Results: Of 15 000 patients tested on a service basis, 1% were seropositive (median, 0.12 nmol/L; range, 0.03-18.8 nmol/L; normal, ≤0.02 nmol/L), 55% were male, and the median age was 65 years. Cancer was found (new or by history) in 24 of 78 patients evaluated for cancer while at Mayo Clinic (30%); 43% had adenocarcinoma (more patients had breast cancer than prostate, lung, and gastrointestinal cancers; each of the latter groups had about the same number of patients). Of 12 patients with high antibody values (≥1.00 nmol/L), 83% had pandysautonomia. Of 85 patients with medium antibody values (0.10-0.99 nmol/L), neurological presentations were more diverse and included peripheral neuropathies (36%), dysautonomia (20%, usually limited), and encephalopathy (13%). Of 58 patients with low antibody values (0.03-0.09 nmol/L), 54% had a nonautoimmune neurological disorder or no neurological disorder. Of 245 control patients with lung cancer, 7.8% were seropositive. Only 1 of 212 control patients without cancer (0.5%) was seropositive (P<.001). Conclusion: The detection of α3-AChR autoantibody aids the diagnosis of neurological autoimmunity and cancer.

AB - Objective: To describe the clinical utility of the nicotinic ganglionic acetylcholine receptor (α3-AChR) autoantibody as a marker of neurological autoimmunity and cancer. Design: Case-control study. Setting: Mayo Clinic, Rochester, Minnesota. Patients: A total of 15 000 patients seen at Mayo Clinic (2005-2007) and evaluated on a service basis for paraneoplastic neurological autoimmunity for whom clinical information was obtained retrospectively by medical record review as well as 457 neurologically asymptomatic patients or control subjects ofwhom173 were healthy, 245 had lung cancer, and 39 had systemic lupus erythematosus or Sjögren syndrome. Outcome Measures: Neurological, oncological, and serological associations of α3-AChR autoantibody seropositivity. Results: Of 15 000 patients tested on a service basis, 1% were seropositive (median, 0.12 nmol/L; range, 0.03-18.8 nmol/L; normal, ≤0.02 nmol/L), 55% were male, and the median age was 65 years. Cancer was found (new or by history) in 24 of 78 patients evaluated for cancer while at Mayo Clinic (30%); 43% had adenocarcinoma (more patients had breast cancer than prostate, lung, and gastrointestinal cancers; each of the latter groups had about the same number of patients). Of 12 patients with high antibody values (≥1.00 nmol/L), 83% had pandysautonomia. Of 85 patients with medium antibody values (0.10-0.99 nmol/L), neurological presentations were more diverse and included peripheral neuropathies (36%), dysautonomia (20%, usually limited), and encephalopathy (13%). Of 58 patients with low antibody values (0.03-0.09 nmol/L), 54% had a nonautoimmune neurological disorder or no neurological disorder. Of 245 control patients with lung cancer, 7.8% were seropositive. Only 1 of 212 control patients without cancer (0.5%) was seropositive (P<.001). Conclusion: The detection of α3-AChR autoantibody aids the diagnosis of neurological autoimmunity and cancer.

UR - http://www.scopus.com/inward/record.url?scp=67049154558&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=67049154558&partnerID=8YFLogxK

U2 - 10.1001/archneurol.2009.78

DO - 10.1001/archneurol.2009.78

M3 - Article

VL - 66

SP - 735

EP - 741

JO - Archives of Neurology

JF - Archives of Neurology

SN - 0003-9942

IS - 6

ER -