Sensitivity and specificity of a commercial ELISA test for anti-MAG antibodies in patients with neuropathy

Liberatore, Giuseppe; Giannotta, Claudia; Sajeev, Blesson Punnen; Morenghi, Emanuela; Terenghi, F.; Gallia, Francesca; Doneddu, Pietro Emiliano; Manganelli, Fiore; Cocito, Dario; Filosto, Massimiliano; Antonini, Giovanni; Cosentino, Giuseppe; Marfia, Girolama Alessandra; Clerici, Angelo Maurizio; Lauria, Giuseppe; Rosso, Tiziana; Cavaletti, Guido; Nobile‐Orazio, Eduardo

doi:10.1016/j.jneuroim.2020.577288

Cited by 23 publications

(22 citation statements)

References 29 publications

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“… The TF advised anti‐MAG antibody testing in all patients with an IgM paraprotein fulfilling CIDP diagnostic criteria (especially distal CIDP) because a high titre of anti‐MAG antibodies (>7000 Bühlmann Titre Units, BTU) 153 would strongly imply a different diagnosis than CIDP. …”

Section: Resultsmentioning

confidence: 99%

European Academy of Neurology/Peripheral Nerve Society guideline on diagnosis and treatment of chronic inflammatory demyelinating polyradiculoneuropathy: Report of a joint Task Force—Second revision

Bergh

Doorn

Hadden

et al. 2021

J Peripheral Nervous Sys

259

393

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Section: Resultsmentioning

confidence: 99%

European Academy of Neurology/Peripheral Nerve Society guideline on diagnosis and treatment of chronic inflammatory demyelinating polyradiculoneuropathy: Report of a joint Task Force—Second revision

Bergh

Doorn

Hadden

et al. 2021

J Peripheral Nervous Sys

259

393

View full text Add to dashboard Cite

show abstract

“… The TF advised anti‐MAG antibody testing in all patients with an IgM paraprotein fulfilling CIDP diagnostic criteria (especially distal CIDP) because a high titre of anti‐MAG antibodies (>7000 Bühlmann Titre Units, BTU) [153] would strongly imply a different diagnosis than CIDP. …”

Section: Resultsmentioning

confidence: 99%

European Academy of Neurology/Peripheral Nerve Society guideline on diagnosis and treatment of chronic inflammatory demyelinating polyradiculoneuropathy: Report of a joint Task Force—Second revision

Bergh

Doorn

Hadden

et al. 2021

Euro J of Neurology

205

282

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Objective To revise the 2010 consensus guideline on chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). Methods Seventeen disease experts, a patient representative, and two Cochrane methodologists constructed 12 Population/Intervention/Comparison/Outcome (PICO) questions regarding diagnosis and treatment to guide the literature search. Data were extracted and summarized in GRADE summary of findings (for treatment PICOs) or evidence tables (for diagnostic PICOs). Results Statements were prepared according to the GRADE Evidence‐to‐Decision frameworks. Typical CIDP and CIDP variants were distinguished. The previous term “atypical CIDP” was replaced by “CIDP variants” because these are well characterized entities (multifocal, focal, distal, motor, or sensory CIDP). The levels of diagnostic certainty were reduced from three (definite, probable, possible CIDP) to only two (CIDP and possible CIDP), because the diagnostic accuracy of criteria for probable and definite CIDP did not significantly differ. Good Practice Points were formulated for supportive criteria and investigations to be considered to diagnose CIDP. The principal treatment recommendations were: (a) intravenous immunoglobulin (IVIg) or corticosteroids are strongly recommended as initial treatment in typical CIDP and CIDP variants; (b) plasma exchange is strongly recommended if IVIg and corticosteroids are ineffective; (c) IVIg should be considered as first‐line treatment in motor CIDP (Good Practice Point); (d) for maintenance treatment, IVIg, subcutaneous immunoglobulin or corticosteroids are recommended; (e) if the maintenance dose of any of these is high, consider either combination treatments or adding an immunosuppressant or immunomodulatory drug (Good Practice Point); and (f) if pain is present, consider drugs against neuropathic pain and multidisciplinary management (Good Practice Point).

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“…At the time of inclusion, patients with an alternative diagnosis for the neuropathy or high titres of anti-MAG (myelin-associated glycoprotein) antibodies (over 7000 Bühlmann Titer Units by Bühlman method)24 or without available nerve conduction studies were excluded.…”

Section: Methodsmentioning

confidence: 99%

Comparison of the diagnostic accuracy of the 2021 EAN/PNS and 2010 EFNS/PNS diagnostic criteria for chronic inflammatory demyelinating polyradiculoneuropathy

Doneddu

Lorenzo

Manganelli

et al. 2022

J Neurol Neurosurg Psychiatry

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ObjectivesTo compare the sensitivity and specificity of the 2021 European Academy of Neurology/Peripheral Nerve Society (EAN/PNS) diagnostic criteria for chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) with those of the 2010 European Federation of Neurological Societies/Peripheral Nerve Society (EFNS/PNS).MethodsSensitivity and specificity of the two sets of criteria were evaluated in 330 patients with CIDP and 166 axonal peripheral neuropathy controls. Comparison of the utility of nerve conduction studies with different number of nerves examined and of the sensitivity and specificity of the two criteria in typical CIDP and its variants were assessed.ResultsEFNS/PNS criteria had a sensitivity of 92% for possible CIDP and 85% for probable/definite CIDP, while the EAN/PNS criteria had a sensitivity of 83% for possible CIDP and 74% for CIDP. Using supportive criteria, the sensitivity of the EAN/PNS criteria for possible CIDP increased to 85% and that of CIDP to 77%, remaining lower than that of the EFNS/PNS criteria. Specificity of the EFNS/PNS criteria was 68% for possible CIDP and 84% for probable/definite CIDP, while the EAN/PNS criteria had a specificity of 88% for possible CIDP and 98% for CIDP. More extended studies increased the sensitivity of both sets of criteria by 4%–7% but reduced their specificity by 2%–3%. The EFNS/PNS criteria were more sensitive for the diagnosis of typical CIDP while the EAN/PNS criteria were more specific for the diagnosis of distal and sensory CIDP.ConclusionsIn our population, the EAN/PNS criteria were more specific but less sensitive than the EFNS/PNS criteria. With the EAN/PNS criteria, more extended nerve conduction studies are recommended to obtain an acceptable sensitivity while maintaining a high specificity.

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Sensitivity and specificity of a commercial ELISA test for anti-MAG antibodies in patients with neuropathy

Cited by 23 publications

References 29 publications

European Academy of Neurology/Peripheral Nerve Society guideline on diagnosis and treatment of chronic inflammatory demyelinating polyradiculoneuropathy: Report of a joint Task Force—Second revision

European Academy of Neurology/Peripheral Nerve Society guideline on diagnosis and treatment of chronic inflammatory demyelinating polyradiculoneuropathy: Report of a joint Task Force—Second revision

European Academy of Neurology/Peripheral Nerve Society guideline on diagnosis and treatment of chronic inflammatory demyelinating polyradiculoneuropathy: Report of a joint Task Force—Second revision

Comparison of the diagnostic accuracy of the 2021 EAN/PNS and 2010 EFNS/PNS diagnostic criteria for chronic inflammatory demyelinating polyradiculoneuropathy

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