Department of Clinical Neurological Sciences, London Health Sciences Centre, Western University, London, Ontario, Canada.
Department of Pathology and Laboratory Medicine, London Health Sciences Centre, Western University, London, Ontario, Canada.
Can J Neurol Sci. 2023 Sep;50(5):766-768. doi: 10.1017/cjn.2022.276. Epub 2022 Jul 21.
High anti-GAD65 levels associate with core manifestations of GAD65 neurological autoimmunity. ELISA cut-offs for high anti-GAD65 levels (>10,000 IU/ml in serum, >100 IU/ml in CSF) have been proposed that merit further evaluation. We reviewed patients who underwent anti-GAD65 ELISA for suspected autoimmune encephalitis and found values above these cut-offs to have a positive predictive value (PPV) for neurological autoimmunity of 88%. Anti-GAD65 values above proposed ELISA cut-offs have a reasonably high PPV for neurological autoimmunity in patients with suspected autoimmune encephalitis. Consideration of alternative diagnoses and corroboration with CSF can help flag potentially clinically irrelevant results and avoid patient misdiagnosis.
高抗谷氨酸脱羧酶 65 抗体水平与谷氨酸脱羧酶 65 神经自身免疫的核心表现相关。已提出了用于高抗谷氨酸脱羧酶 65 抗体水平（血清 >10,000IU/ml，CSF >100IU/ml）的 ELISA 截断值，值得进一步评估。我们回顾了接受抗谷氨酸脱羧酶 65ELISA 检查以怀疑自身免疫性脑炎的患者，发现这些截断值以上的抗体值对神经自身免疫的阳性预测值（PPV）为 88%。在怀疑自身免疫性脑炎的患者中，抗谷氨酸脱羧酶 65 抗体值高于建议的 ELISA 截断值对神经自身免疫具有相当高的 PPV。考虑其他诊断并与 CSF 相符有助于标记潜在的无临床意义的结果，并避免误诊。
