P/Q- and N-type calcium-channel antibodies: Oncological, neurological, and serological accompaniments

Muscle Nerve. 2016 Aug;54(2):220-7. doi: 10.1002/mus.25027. Epub 2016 Feb 8.

Abstract

Introduction: 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.

Keywords: ataxia; calcium channel; myasthenia; neuropathy; paraneoplastic.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Autoantibodies / blood*
  • Autoantibodies / cerebrospinal fluid
  • Calcium Channels, N-Type / immunology*
  • Cognition Disorders / blood
  • Cognition Disorders / immunology
  • Female
  • Humans
  • Lung Neoplasms / blood*
  • Lung Neoplasms / cerebrospinal fluid
  • Lung Neoplasms / immunology
  • Male
  • Middle Aged
  • Nervous System Diseases / blood*
  • Nervous System Diseases / cerebrospinal fluid
  • Nervous System Diseases / immunology
  • Paraneoplastic Polyneuropathy / blood*
  • Paraneoplastic Polyneuropathy / cerebrospinal fluid
  • Paraneoplastic Polyneuropathy / immunology
  • Young Adult

Substances

  • Autoantibodies
  • Calcium Channels, N-Type