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Anti‐sulfatide IgM antibodies in peripheral neuropathy: to test or not to test?
Author(s) -
Giannotta C.,
Di Pietro D.,
Gallia F.,
NobileOrazio E.
Publication year - 2015
Publication title -
european journal of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.881
H-Index - 124
eISSN - 1468-1331
pISSN - 1351-5101
DOI - 10.1111/ene.12658
Subject(s) - medicine , antibody , titer , peripheral neuropathy , immunology , immunoglobulin m , concomitant , gastroenterology , immunoglobulin g , endocrinology , diabetes mellitus
Background and purpose Anti‐sulfatide immunoglobulin M (IgM) antibodies have been associated with different forms of neuropathies but their diagnostic role in neuropathy remains unclear. Methods The clinical association of increased titers of anti‐sulfatide IgM antibodies in 570 patients with neuropathy and related disorders examined in our laboratory since 2004 was reviewed. Sera were tested by enzyme‐linked immunosorbent assay at the initial serum dilution of 1:32 000 and titrated by serial two‐fold dilution. In all positive patients IgM antibodies to myelin‐associated glycoprotein ( MAG ) were also measured by western blot. Results High titers of anti‐sulfatide antibodies were found in 39 patients including 33 (85%) who also had anti‐ MAG IgM. Six patients did not have anti‐ MAG IgM including five in whom moderately increased anti‐sulfatide titers were associated with different forms of neuropathy. One patient with a demyelinating neuropathy and IgM monoclonal gammopathy had markedly increased anti‐sulfatide titers (1:256 000). Conclusions Increased titers of anti‐sulfatide IgM antibodies are not infrequent in patients with neuropathy where they are often associated with a concomitant reactivity to MAG . A selective reactivity to sulfatide, however, is rarely found and is associated with different forms of neuropathy limiting its usefulness in the diagnosis of neuropathy.