Autoantibody interpretations

Autoimmunity

Anti-Glianin antibody

Neuronal Nuclear (Hu) Antibodies (NNA)

Paraneoplastic neuronal antibody panel

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********* Anti Gliadin Antibody **********

 
 
Test                   RESULT              REFERENCE RANGE
 
 
IgG Antibody         <15 (Negative)            <15
 
IgA Antibidy         <4  (Negative)            <4
 
 
IgA Anti-Gliadin antibody (AGA) is a marker of Celiac disease
associated with Gluten-Sensitive Enteropathy or Dermatitis
Herpetiformis. AGA is less sensitive but more specific than IgG
Anti-Gliadin antibody (GGA). Adherence to a gluten-free diet will
result in decreased AGA in 2-6 months. AGA is present at the
following frequencies: Gluten-Sensitive Enteropathy 90%, Dermatitis
Herpetiformis 30%-60%, Crohn's Disease 15%, and Atopic Dermatitis
10%. The presence of both IgG and IgA Anti-Gliadin antibody indicates
a high probability of Celiac disease.

********* Anti Gliadin Antibody **********

Test RESULT REFERENCE RANGE

IgG Antibody <15 (Negative) <15

IgA Antibidy <4 (Negative) <4

IgA Anti-Gliadin antibody (AGA) is a marker of Celiac disease associated with Gluten-Sensitive Enteropathy or Dermatitis Herpetiformis. AGA is less sensitive but more specific than IgG Anti-Gliadin antibody (GGA). AGA is present at the following frequencies: Gluten-Sensitive Enteropathy 90%, Dermatitis Herpetiformis 30%-60%, Crohn's Disease 15%, and Atopic Dermatitis 10%. The presence of both IgG and IgA Anti-Gliadin antibody indicates a high probability of Celiac disease.ےےےےےےےےےےےےےےےےےےےےےےےTOP_____________MAIN

**** Neuronal Nuclear (Hu) Antibodies (NNA).****

TEST NAME RESULTS REFERENCE RANGE

Neuronal Nuclear (Hu) Ab Ser Less than 10 Less than 10 U/mL

Interpretation: Negative test result for Neuronal Nuclear (Hu) Antibodies (NNA). NNA are found in a number of paraneoplastic syndromes, including subacute sensory neuronopathy, paraneoplastic encephalomyelitis and paraneoplastic cerebellar degeneration and are associated with small cell lung carcinoma. A negative result for NNA does not exclude the possibility of a malignant tumor.

ANTI-NEURONAL NUCLEAR ANTIBODIES-TYPE 2 (ANNA-2)


TEST RESULT REF RANGE INTERPRETATION

Anti-Neuronal Nuclear <1:60 titer <1:60 titer NEGATIVE
Antibody-Type2, serum

This patient's serum is negative for anti-neuronal nuclear antibodies-type 2 (ANNA-2). However, tests on 10/30/95 indicated that this patient's serum contained high titer (1:3840) of anti-neuronal nuclear antibodies-type 1 (ANNA-1), which is suspicious for paraneoplastic autoimmune neurologic disease secondary to small cell lung carcinoma.

Anti-neuronal nuclear antibodies-Type 2 (ANNA-2) can be found in the serum or CSF of patients with paraneoplastic autoimmune neurologic disorders secondary to lung, breast or gynecologic carcinomas.

Assays for ANNA-1 and ANNA-2 are not recommended as a general screening tests for lung, breast or gynecologic malignancies. However, they are useful in patients with unexplained neurologic symptoms that could be explained by a paraneoplastic process. Positive tests can occur even when the primary malignancy is still occult.


******* NEURONAL NUCLEAR (Hu) ANTIBODIES *******

TEST RESULT REFERENCE RANGE

NEURONAL NUCLEAR (Hu) Ab NOT DETECTED NOT DETECTED

NEURONAL NUCLEAR (Hu) ANTIBODIES, CSF, IB: CNS paraneoplastic syndromes (neurological disorders which occur as a remote effect of a cancer) are generally thought to be the result of an autoimmune process in which the antibodies to antigens expressed in tumor tissue are directed against similar antigens of the central nervous system. Neuronal nuclear antibodies (NNA; also known as Hu antibodies) are found in a number of paraneoplastic syndromes, including subacute sensory neuropathy (SSN), paraneoplastic encephalomyeitis (PN), and paraneoplastic cerebellar degeneration (PCD) and are associated with small-cell lung cancer.

Test performed by Specialty Laboratories, Inc.

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***** PARANEOPLASTIC NEURONAL ANTIBODY PANEL A *****

ANALYTE **PATIENT** --REFERENCE VALUES--
Antineuronal Nuclear Ab-
Type 1 (ANNA-1), Serum Negative <1:60 <1:60

Antineuronal Nuclear Ab-
Type 2 (ANNA-2), Serum Negative <1:60 <1:60

Purkinje Cell Cytoplasmic Ab
(Cerebellum)-
Serum Negative <1:60 <1:60

Interpretation: All values are within normal limits.

A spectrum of paraneoplastic neurologic disorders is found with ANNA-1 and 2. Most frequent are neuropathies: pure sensory, predominantly autonomic, mixed sensorimotor, and least commonly, predominantly motor. The test is useful in aiding in the diagnosis of SCLC in patients who have complex neurological abnormalities with a history of tobacco abuse.

Purkinje cell cytoplasmic antibodies are useful for identifying individuals with subacute cerebellar degeneration or peripheral neuropathy due to a remote (autoimmune) effect of gynecologic or breast carcinoma.














******** SPINAL FLUID ***********
***** PARANEOPLASTIC NEURONAL ANTIBODY PANEL A *****

ANALYTE **PATIENT** --REFERENCE VALUES--
Antineuronal Nuclear Ab-
Type 1 (ANNA-1), SPINAL FLUID Negative <1:2

Antineuronal Nuclear Ab-
Type 2 (ANNA-2), SPINAL FLUID Negative <1:2

Purkinje Cell Cytoplasmic Ab
(Cerebellum)-
SPINAL FLUIDNegative Negative <1:2

Interpretation: All values are within normal limits.

A spectrum of paraneoplastic neurologic disorders is found with ANNA-1 and 2. Most frequent are neuropathies: pure sensory, predominantly autonomic, mixed sensorimotor, and least commonly, predominantly motor. The test is useful in aiding in the diagnosis of SCLC in patients who have complex neurological abnormalities with a history of tobacco abuse.

Purkinje cell cytoplasmic antibodies are useful for identifying individuals with subacute cerebellar degeneration or peripheral neuropathy due to a remote (autoimmune) effect of gynecologic or breast carcinoma.

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******* Proteinase-3 Ab (ANCA) ******

Test name Results Reference ranges

Proteinase-3 Ab Less than 10 Less than 10 EIA Units

Results confirmed by repeat analysis
Reference range for Proteinase-3 antibodies
<10 EIA Units Not detected
10-15 Indeterminate
16-30 Weakly positive
31-100 Positive
>100 Strongly ositive


PROTEINASE-3 (PR-3) Antibodies. EIA: PR-3, a 29 kd enzyme located in the azurophil (primary) granules of neutrophils, is the major target of antineutrophil cytoplasmic antibodies (ANCA) which give a cytoplasmic (C-ANCA) immunofluorescence pattern. Antibodies to PR-3 are detected in 60-70% of C-ANCA positive samples. Elevated levels of PR-3 antibodies are classically observed in patients with Wegener granulomatosis (WG), particularly with active disease and less frequently in other forms of necrotizing vasculitis. The detection of PR-3 antibodies is useful in corroboration of C-ANCA positivity and in the diagnosis of WG as well as for assessing disease activity and response to therapy. Levels of PR-3 antibodies generally correlate with C-ANCA titers, but not always in a linear fashion due to the possible involvement of other antigen specificities for this group of ANCA. Monitoring can be clinically useful.

********** MYELOPEROXIDASE (MPO) ANTIBODIES BY EIA **********

Antibody ---------- Results --------- Reference Range

Myeloperoxidase Ab Less than 10 Less than 10 EIA units

Interpretation:

Myeloperoxidase is the main target antigen for the antineutrophil cytoplasmic antibodies (ANCA) which give a perinuclear (P-ANCA) pattern. MPO antibodies are detected in 80-90% of P-ANCA-positive samples. Elevated levels of MPO antibodies by EIA are observed in patients with active pauci-immune idiopathic necrotizing and crescentic glomerulonephritis, microscopic polyarteritis and some active Wegener granulomatosis with renal involvement.

The detection of MPO antobodies is useful for the corroboration of P-ANCA positivity. Monitoring can be clinically useful.




****ANTI-PROTEINASE-3 ANTIBODIES BY EIA (C-ANCA WORK-UP)****

TEST RESULT REFERENCE RANGE INTERPRETATION
Anti-Proteinase-3 Ab <10 EIA Unit <10 EIA Unit NEGATIVE
Anti-Myeloperoxidase <10 EIA Unit <10 EIA Unit NEGATIVE
(MPO)


********** MYELOPEROXIDASE (MPO) ANTIBODIES BY EIA **********

Antibody ---------- Results --------- Reference Range

Myeloperoxidase Ab Less than 10 Less than 10 EIA units

Interpretation:

Myeloperoxidase is the main target antigen for the antineutrophil cytoplasmic antibodies (ANCA) which give a perinuclear (P-ANCA) pattern. MPO antibodies are detected in 80-90% of P-ANCA-positive samples. Elevated levels of MPO antibodies by EIA are observed in patients with active pauci-immune idiopathic necrotizing and crescentic glomerulonephritis, microscopic polyarteritis and some active Wegener granulomatosis with renal involvement.

The detection of MPO antobodies is useful for the corroboration of P-ANCA positivity. Monitoring can be clinically useful.

All sera are stored frozen for six weeks for additional testing.

This patient was previously shown to produce low titer P-ANCA autoantibody. Assays for anti-proteinase-3 autoantibodies are useful for corroborating positive C-ANCA assays. This negative assay was expected.


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