Abstract
"Antibody of Unknown Significance" (AUS): The Issue of Interpreting Antibody Test Results.
Highlights
Antibodies against the dopamine 2 receptor were originally described and detected by tissue-based immunohistochemistry (tIHC) and cell-based assay (CBA),[21] but ambiguous findings resulted from testing by enzyme-linked immunosorbent assay (ELISA), a test detecting antibodies to peptides or linear epitopes.[22,23]
antibody of unknown significance” (AUS) poses a significant problem in clinical practice
Misdiagnosis as an autoimmune movement disorder may be harmful by delaying the correct diagnosis and treatment, and exposing patients to potentially harmful immunosuppression
Summary
Antibodies are important for the diagnosis in autoimmune movement disorders, but the latter should not rely on antibody tests alone, but on the conjuncture of clinical and paraclinical findings. Antibodies against the dopamine 2 receptor were originally described and detected by tIHC and CBA,[21] but ambiguous (and sensu stricu, false-positive) findings resulted from testing by ELISA, a test detecting antibodies to peptides or linear epitopes.[22,23] laboratories may offer tests for dopamine 2 receptor–like antibodies or “basal ganglia antibodies” that are not useful in the diagnosis of autoimmune movement disorders.[24,25] Laboratories may offer testing for IgM or IgA antibodies,[10] but existing evidence would caution against ascribing them a diagnostic or pathogenic relevance.[26,27]. It is of the utmost importance to ensure the appropriate test has been selected in the first place and that results can be replicated in a second, confirmatory test
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