Abstract
Anti-neuronal antibodies are associated with a range of clinical phenotypes that are often preceded by malignancy. Most of these antibodies can be identified by indirect immunofluorescence (IIF) using commercial primate neural tissue slides. The EUROImmun 12 and upgraded RAVO 14 antigen line immunoblots were directly compared to replace a 9 antigen RAVO immunoblot. Initial assessment was with samples with known positive specificities by IIF. The second phase involved parallel testing of routine pooled negative IIF samples as per institutional standard antineuronal testing algorithm. IIF results and clinical correlation were used to arbitrate on discordant immunoblot results. Correlation in known positives was 80%. The EUROImmun immunoblot did not identify disease causing SOX1 and Recoverin antibodies. Routine pooled analysis did not identify discrepancy between the platforms. Assessment of 318 patient samples did not reveal any cases where a diagnosis was correctly identified by line immunoblot and not IIF. A single sample with positive Yo antibodies was identified by both platforms without clinical or IIF correlation, making this a likely false positive. Subsequent to this audit, Westmead ICPMR has migrated to the 14 antigen RAVO line blot for confirmation of positive IIF or for patients with equivocal results only.
Published Version
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