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

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

doi:10.1016/j.jneuroim.2020.577288

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

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

Research output: Contribution to journal › Article › peer-review

Abstract

For the diagnosis of anti-MAG polyneuropathy the commercial ELISA manufacturer currently recommends a cut-off of 1000 Bühlmann Titer Units (BTU). We analyzed sera from 80 anti-MAG neuropathy patients and 383 controls (with other neuropathies or healthy controls) to assess the ELISA sensitivity and specificity at different thresholds. A better combination of sensitivity/specificity was found at a threshold >1500 BTU than at >1000 BTU. The best value of specificity was obtained at threshold >7000 BTU. There was a diagnostic grey area between 1500 and 7000 BTU in which the clinical phenotypes as well as electrophysiological studies need to be carefully assessed particularly to differentiate CIDP and anti-MAG neuropathy.

Original language	English
Journal	Journal of Neuroimmunology
Volume	345
DOIs	https://doi.org/10.1016/j.jneuroim.2020.577288
Publication status	Published - Aug 15 2020

Keywords

Anti-MAG polyneuropathy, chronic inflammatory demyelinating polyradiculoneuropathy
ELISA
Sensitivity
Specificity

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Liberatore, G., Giannotta, C., Sajeev, B. P., Morenghi, E., Terenghi, F., Gallia, F., Doneddu, P. E., Manganelli, F., Cocito, D., Filosto, M., Antonini, G., Cosentino, G., Marfia, G. A., Clerici, A. M., Lauria, G., Rosso, T., Cavaletti, G., & Nobile-Orazio, E. (2020). Sensitivity and specificity of a commercial ELISA test for anti-MAG antibodies in patients with neuropathy. Journal of Neuroimmunology, 345. https://doi.org/10.1016/j.jneuroim.2020.577288

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, Fabrizia ; 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.

In: Journal of Neuroimmunology, Vol. 345, 15.08.2020.

Research output: Contribution to journal › Article › peer-review

Liberatore, G , Giannotta, C, Sajeev, BP, Morenghi, E, Terenghi, F , Gallia, F , Doneddu, PE, Manganelli, F, Cocito, D, Filosto, M, Antonini, G, Cosentino, G, Marfia, GA, Clerici, AM, Lauria, G, Rosso, T, Cavaletti, G & Nobile-Orazio, E 2020, 'Sensitivity and specificity of a commercial ELISA test for anti-MAG antibodies in patients with neuropathy', Journal of Neuroimmunology, vol. 345. https://doi.org/10.1016/j.jneuroim.2020.577288

Liberatore, Giuseppe ; Giannotta, Claudia ; Sajeev, Blesson Punnen ; Morenghi, Emanuela ; Terenghi, Fabrizia ; 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. / Sensitivity and specificity of a commercial ELISA test for anti-MAG antibodies in patients with neuropathy. In: Journal of Neuroimmunology. 2020 ; Vol. 345.

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abstract = "For the diagnosis of anti-MAG polyneuropathy the commercial ELISA manufacturer currently recommends a cut-off of 1000 B{\"u}hlmann Titer Units (BTU). We analyzed sera from 80 anti-MAG neuropathy patients and 383 controls (with other neuropathies or healthy controls) to assess the ELISA sensitivity and specificity at different thresholds. A better combination of sensitivity/specificity was found at a threshold >1500 BTU than at >1000 BTU. The best value of specificity was obtained at threshold >7000 BTU. There was a diagnostic grey area between 1500 and 7000 BTU in which the clinical phenotypes as well as electrophysiological studies need to be carefully assessed particularly to differentiate CIDP and anti-MAG neuropathy.",

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AU - Liberatore, Giuseppe

AU - Giannotta, Claudia

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AU - Terenghi, Fabrizia

AU - Gallia, Francesca

AU - Doneddu, Pietro Emiliano

AU - Manganelli, Fiore

AU - Cocito, Dario

AU - Filosto, Massimiliano

AU - Antonini, Giovanni

AU - Cosentino, Giuseppe

AU - Marfia, Girolama Alessandra

AU - Clerici, Angelo Maurizio

AU - Lauria, Giuseppe

AU - Rosso, Tiziana

AU - Cavaletti, Guido

AU - Nobile-Orazio, Eduardo

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AB - For the diagnosis of anti-MAG polyneuropathy the commercial ELISA manufacturer currently recommends a cut-off of 1000 Bühlmann Titer Units (BTU). We analyzed sera from 80 anti-MAG neuropathy patients and 383 controls (with other neuropathies or healthy controls) to assess the ELISA sensitivity and specificity at different thresholds. A better combination of sensitivity/specificity was found at a threshold >1500 BTU than at >1000 BTU. The best value of specificity was obtained at threshold >7000 BTU. There was a diagnostic grey area between 1500 and 7000 BTU in which the clinical phenotypes as well as electrophysiological studies need to be carefully assessed particularly to differentiate CIDP and anti-MAG neuropathy.

KW - Anti-MAG polyneuropathy, chronic inflammatory demyelinating polyradiculoneuropathy

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