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Contact Information Box 8111 - Neurology 660 South Euclid Avenue St. Louis, MO 63110 Phone: 314-362-2406 Fax: 314-362-3413 e-mail: pestronka@wustl.edu Instructions on sending Antibody testing, or Biopsies: Muscle or Nerve Phone: 314-362-2406 Laboratory certifications CAP Lab # 19233-16 Medicare Provider # 26-8235 CLIA Certificate # 26D0652044 New York State 3499 California COS 00800679 Florida 800028650 |
Testing at Washington University Laboratory: Specific tests Requisition forms & Information Antibodies Sending samples: Instructions Biopsies: Muscle, Nerve & Skin Muscle instructions Freezing; Other Nerve instructions General; Surgery; Freezing; Other technical Skin instructions Antibodies General principles Classification Binding to oligosaccharides Glycoproteins & Glycolipids Specific types Testing methods Survey |
![]() ![]() Charcot's clinic |
Antibody | Antigen | Disease | ||||||
Class | Location | Type | Pathogenic properties |
Features | Antigen Examples |
Neuromuscular Disease Examples |
Associations, Systemic |
Common treatments |
IgG | Serum | Polyclonal | Often |
Protein Cell surface membrane |
Receptors: AChRs Muscle; Neuron Ca++ ion channels K+ channel complex |
Myasthenia gravis Autonomic PN LEMS Isaac's |
Neoplasms Thymoma Adeno Ca Small cell lung |
Corticosteroids T-cell suppressants IVIg Plasma Exchange |
IgG | Serum | Polyclonal | Possible | Carbohydrate Glycolipid |
Gangliosides GM1 GQ1b GD1b |
AMAN Miller-Fisher Sensory, Acute |
Infection, Prodromal |
Disease often monophasic |
IgG | Serum | Polyclonal | Few | Protein Intracellular |
tRNA synthetases SRP ANCA FGFR3 |
IMPP Polymyopathy, immune Vasculitis Neuropathy, Sensory |
Organ system disease, or Neoplasm, or None |
Corticosteroids T-cell suppressants Rituximab |
IgG | Serum + CSF | Polyclonal | No | Protein Intracellular |
Hu (Neuron nuclei) CRMP5 |
Neuronopathy Sensory; Autonomic Polyneuropathy |
Neoplasms Small cell lung Gynecologic |
Screen for & Treat Associated neoplasm |
IgG4 | Serum | Polyclonal | Possible |
Protein Cell surface, or Extracellular |
MuSK Neurofascins 140 155 Contactin-1 Lgi1 Caspr2 |
MG-MuSK PN Sensory ataxia, subacute Demyel +: Tremor; CNS Demyel PN: IVIg resistant Encephalopathy ± PN Neuromyotonia; Autonomic |
None |
Rituximab (q 1-6 mo) Corticosteroids |
IgM | Serum | Monoclonal or Polyclonal |
Possible | Carbohydrate Glycolipid or Glycoproteins |
GM1 MAG TS-HDS GD1b |
Motor PN Demyelinating PN Sensory PN Sensory PN, Ataxic |
Neoplasms M-protein |
Rituximab (IgM ↓) Intravenous Ig (Conduction block) Cyclophosphamide |
IgM, IgG, or IgA |
Serum | Monoclonal | Some | Not identified | Polyneuropathy | POEMS Cryoglobulins Waldenström's |
Radiate; Chemo; Stem cell Rituximab; Chemo |
GalNAc-GD1a ganglioside GALOP antigen GD1b ganglioside GD1a ganglioside GD3 ganglioside GM1 ganglioside Co-GM1; GM1; NP-9 GM1b ganglioside GM2 ganglioside GQ1b ganglioside GT1a ganglioside Heparan sulfate Lysoganglioside-GM1 MAG NS6S SGPG Sulfatide GALOP antigen TS-HDS |
Galβ1-3GalNAcβ1-4Galβ1-4Glcβ1-1'Ceramide 3 | Neu5Acα2 |
Galβ1-3GalNAcβ1-4Galβ1-X 3 | Neu5Acα2 |
SO4-3Galactose-X Target epitope: Sulfatide
|
SO4-3Glucuronate-X Target epitope: MAG & SGPG
|
SO4-3GlcAβ1-3Galβ1-4GlcNAcβ1-3Galβ1-4Glcβ1-1'Ceramide SGPG
|
SO4-3Glucuronate-X Target epitope: SGPG & MAG
|
Galβ1-3GalNAcβ1-4Galβ1-X 3 3 | | Neu5Acα2-8Neu5Acα2 | Neu5Acα2-8Neu5Acα2 Target epitope: GQ1b
|
Galβ1-3GalNAcβ1-4Galβ1-X 3 3 | | Neu5Acα2-8Neu5Acα2 | Neu5Acα2 Target epitope: GT1a
|
Galβ1-3GalNAcβ1-4Galβ1-4Glcβ1-1'Ceramide 3 | Neu5Acα2-8Neu5Acα2 |
Y-4Galβ1-X 3 | Neu5Acα2-8Neu5Acα2 Target epitope: GD1b
|
Galβ1-3GalNAcβ1-4Galβ1-4Glcβ1-1'Ceramide 3 | Neu5Acα2 |
Galβ1-3GalNAcβ1-4Galβ1-4Glcβ1-1'Ceramide 3 3 | | Neu5Acα2 Neu5Acα2 |
Galβ1-X 3 | Neu5Acα2 Target epitope: GD1a
|
GalNAcβ1-4Galβ1-X 3 | Neu5Acα2Target epitope: GalNAc-GD1a and GM2 |
Gal-CeramideGalactocerebroside |
General principles Enzyme-linked immunosorbent assays (ELISA) Immunocytochemistry Immunofixation Thin layer chromatography (TLC) Western blot |
Antibody | Age & Sex | Syndrome | Neoplasm |
NMDAR
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Age 37%<18 years 5%>44 years Sex: 80% female |
Panencephalitis Psychiatric at onset |
Ovary teratoma (35%) Young fertile women 12–44 years(55–60%) |
AMPAR
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Age: 23–87 years Female predominant |
Limbic encephalitis Psychosis, rare |
Thymoma Small cell lung Breast |
GABAAR
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Age: 3–63 Male predominant |
Limbic encephalitis Seizures, refractory |
None |
GABABR
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Age: 16–85 years Male = Female |
Limbic encephalitis Seizures, refractory |
Small cell lung |
mGluR1
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Age: 19–65 years |
Cerebellar degeneration | Hodgkin's lymphoma |
mGluR5
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Age: 15–46 years Male = Female |
Limbic encephalitis |
Hodgkin's lymphoma |
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