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The diagnostic value of the presence of anti-neuronal antibodies in serum was examined in 21 patients suspected of paraneoplastic disorders of the nervous system(NS)(group 1)and was compared to three control groups;group 2:25 patients with a neurological disease,without cancer and no signs of paraneoplastic disorder;group 3:27 patients with neurological disease and cancer and no signs of a paraneoplastic disorder;group 4:94 patients with cancer and without neurological disease.In group 1,anti-neuronal nuclear antibodies were detected in eight patients(38%),in titres from 1:1000 to 1:32000.A small cell lung cancer was present in six patients,ovarian cancer in one patient and in one patient no tumour could be detected.The neurological symptoms preceded a diagnosis of cancer in five out of eight patients.Anti-neuronal antibodies were found in the serum of two out of 94 patients(2%)from control group 3 but not in serum from any of the other control groups.These data indicate a moderate sensitivity of 38%,but a high specificity of 98.6%(95%confidence interval 95.5-99.8%)for the presence of anti-neuronal nuclear antibodies if a paraneoplastic NS disorder is suspected. |
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