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P/Q‐ and N‐type calcium‐channel antibodies: Oncological, neurological, and serological accompaniments
Author(s) -
Zalewski Nicholas L.,
Len Vanda A.,
Lachance Daniel H.,
Klein Christopher J.,
Pittock Sean J.,
Mckeon Andrew
Publication year - 2016
Publication title -
muscle and nerve
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.025
H-Index - 145
eISSN - 1097-4598
pISSN - 0148-639X
DOI - 10.1002/mus.25027
Subject(s) - medicine , autoantibody , asymptomatic , encephalopathy , lung cancer , ataxia , pathology , cancer , neurological examination , lambert eaton myasthenic syndrome , serology , gastroenterology , antibody , immunology , surgery , psychiatry
Voltage‐gated calcium‐channel autoimmunity (VGCC‐P/Q and VGCC‐N types) occurs beyond Lambert–Eaton syndrome and lung cancer. Methods We reviewed records for 236 Mayo Clinic patients with VGCC antibodies found in evaluation for paraneoplastic neurological autoimmunity (generally without myasthenic syndromes). Results VGCC autoantibodies were detected in 3.4% of neurological patients, 1.7% of healthy controls, and 4% of neurologically asymptomatic lung cancer controls. Fifty neurological patients (21%) had ≥ 1 neoplasm, historically (46) or detected prospectively [small‐cell lung carcinoma (2), breast adenocarcinoma (2), lymphoma (1), and suspected tonsillar carcinoma (1)]. Autoimmune neurological diagnosis frequencies (encephalopathy, ataxia, myelopathy, neuropathy, neuromuscular junction disorder, and myopathy) among patients with medium values (24%; 0.10–0.99 nmol/L) or low values (19%; 0.03–0.10 nmol/L) were fewer than among patients with antibody values exceeding 1.00 nmol/L (71%; P = 0.02 and 0.004, respectively). Conclusions Among neuronal VGCC‐autoantibody–seropositive patients, autoimmune neurological phenotypes and cancer types are diverse. Cautious interpretation of results (particularly medium and low values) is advised. Muscle Nerve , 2016 Muscle Nerve 54 : 220–227, 2016