P/Q- and N-type calcium-channel antibodies: Oncological, neurological, and serological accompaniments

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Abstract

Introduction: Voltage-gated calcium-channel autoimmunity (VGCC-P/Q and VGCC-N types) occurs beyond Lambert–Eaton syndrome and lung cancer. Methods: We reviewed records for 236 Mayo Clinic patients with VGCC antibodies found in evaluation for paraneoplastic neurological autoimmunity (generally without myasthenic syndromes). Results: VGCC autoantibodies were detected in 3.4% of neurological patients, 1.7% of healthy controls, and 4% of neurologically asymptomatic lung cancer controls. Fifty neurological patients (21%) had ≥ 1 neoplasm, historically (46) or detected prospectively [small-cell lung carcinoma (2), breast adenocarcinoma (2), lymphoma (1), and suspected tonsillar carcinoma (1)]. Autoimmune neurological diagnosis frequencies (encephalopathy, ataxia, myelopathy, neuropathy, neuromuscular junction disorder, and myopathy) among patients with medium values (24%; 0.10–0.99 nmol/L) or low values (19%; 0.03–0.10 nmol/L) were fewer than among patients with antibody values exceeding 1.00 nmol/L (71%; P = 0.02 and 0.004, respectively). Conclusions: Among neuronal VGCC-autoantibody–seropositive patients, autoimmune neurological phenotypes and cancer types are diverse. Cautious interpretation of results (particularly medium and low values) is advised. Muscle Nerve, 2016 Muscle Nerve 54: 220–227, 2016.

Original languageEnglish (US)
Pages (from-to)220-227
Number of pages8
JournalMuscle and Nerve
Volume54
Issue number2
DOIs
StatePublished - Aug 1 2016

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Q-Type Calcium Channels
N-Type Calcium Channels
Antibodies
Autoimmunity
Lung Neoplasms
Neuromuscular Junction Diseases
Muscles
Spinal Cord Diseases
Muscle Weakness
Small Cell Lung Carcinoma
Brain Diseases
Muscular Diseases
Ataxia
Calcium Channels
Autoantibodies
Lymphoma
Neoplasms
Adenocarcinoma
Breast
Carcinoma

Keywords

  • ataxia
  • calcium channel
  • myasthenia
  • neuropathy
  • paraneoplastic

ASJC Scopus subject areas

  • Clinical Neurology
  • Cellular and Molecular Neuroscience
  • Physiology (medical)
  • Physiology

Cite this

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title = "P/Q- and N-type calcium-channel antibodies: Oncological, neurological, and serological accompaniments",
abstract = "Introduction: Voltage-gated calcium-channel autoimmunity (VGCC-P/Q and VGCC-N types) occurs beyond Lambert–Eaton syndrome and lung cancer. Methods: We reviewed records for 236 Mayo Clinic patients with VGCC antibodies found in evaluation for paraneoplastic neurological autoimmunity (generally without myasthenic syndromes). Results: VGCC autoantibodies were detected in 3.4{\%} of neurological patients, 1.7{\%} of healthy controls, and 4{\%} of neurologically asymptomatic lung cancer controls. Fifty neurological patients (21{\%}) had ≥ 1 neoplasm, historically (46) or detected prospectively [small-cell lung carcinoma (2), breast adenocarcinoma (2), lymphoma (1), and suspected tonsillar carcinoma (1)]. Autoimmune neurological diagnosis frequencies (encephalopathy, ataxia, myelopathy, neuropathy, neuromuscular junction disorder, and myopathy) among patients with medium values (24{\%}; 0.10–0.99 nmol/L) or low values (19{\%}; 0.03–0.10 nmol/L) were fewer than among patients with antibody values exceeding 1.00 nmol/L (71{\%}; P = 0.02 and 0.004, respectively). Conclusions: Among neuronal VGCC-autoantibody–seropositive patients, autoimmune neurological phenotypes and cancer types are diverse. Cautious interpretation of results (particularly medium and low values) is advised. Muscle Nerve, 2016 Muscle Nerve 54: 220–227, 2016.",
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author = "Zalewski, {Nicholas L.} and Lennon, {Vanda A} and Lachance, {Daniel H} and Klein, {Christopher Jon} and Pittock, {Sean J} and McKeon, {Andrew B}",
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AU - Lennon, Vanda A

AU - Lachance, Daniel H

AU - Klein, Christopher Jon

AU - Pittock, Sean J

AU - McKeon, Andrew B

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N2 - Introduction: Voltage-gated calcium-channel autoimmunity (VGCC-P/Q and VGCC-N types) occurs beyond Lambert–Eaton syndrome and lung cancer. Methods: We reviewed records for 236 Mayo Clinic patients with VGCC antibodies found in evaluation for paraneoplastic neurological autoimmunity (generally without myasthenic syndromes). Results: VGCC autoantibodies were detected in 3.4% of neurological patients, 1.7% of healthy controls, and 4% of neurologically asymptomatic lung cancer controls. Fifty neurological patients (21%) had ≥ 1 neoplasm, historically (46) or detected prospectively [small-cell lung carcinoma (2), breast adenocarcinoma (2), lymphoma (1), and suspected tonsillar carcinoma (1)]. Autoimmune neurological diagnosis frequencies (encephalopathy, ataxia, myelopathy, neuropathy, neuromuscular junction disorder, and myopathy) among patients with medium values (24%; 0.10–0.99 nmol/L) or low values (19%; 0.03–0.10 nmol/L) were fewer than among patients with antibody values exceeding 1.00 nmol/L (71%; P = 0.02 and 0.004, respectively). Conclusions: Among neuronal VGCC-autoantibody–seropositive patients, autoimmune neurological phenotypes and cancer types are diverse. Cautious interpretation of results (particularly medium and low values) is advised. Muscle Nerve, 2016 Muscle Nerve 54: 220–227, 2016.

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