Sensitivity and specificity of decreased CSF asialotransferrin for eIF2B-related disorder
| Autor: | Odile Boespflug-Tanguy, Raphael Schiffmann, Laetitia Horzinski, Margaret Timmons, Yetrib Hathout, Adeline Vanderver, Michelle Mintz, Eric P. Hoffman, Anne Fogli, F. Niel, Erynn Gordon, Jelena Maletkovic |
|---|---|
| Rok vydání: | 2008 |
| Předmět: |
Adult
medicine.medical_specialty Neurology Asialoglycoproteins Gene mutation medicine.disease_cause Sensitivity and Specificity Article Cerebrospinal fluid medicine Humans Child chemistry.chemical_classification Mutation business.industry Dementia Vascular Leukodystrophy Transferrin Infant medicine.disease Leukodystrophy Globoid Cell Eukaryotic Initiation Factor-2B chemistry Child Preschool Immunology Mutation testing Biomarker (medicine) Neurology (clinical) business Biomarkers |
| Zdroj: | Neurology. 70:2226-2232 |
| ISSN: | 1526-632X 0028-3878 |
| DOI: | 10.1212/01.wnl.0000313857.54398.0e |
| Popis: | This is a study estimating diagnostic accuracy of CSF asialotransferrin to transferrin ratio measurement in eIF2B related disorders by using clinical evaluation and EIF2B mutation analysis as the reference standard. eIF2B-related disorder is a relatively common leukodystrophy with broad phenotypic variation that is caused by mutations in any of the five EIF2B genes. There is a need for a simple and clinically valid screening tool for physicians evaluating patients with an unclassified leukodystrophy.CSF two-dimensional gel (2DG) electrophoresis analyses to measure asialotransferrin to transferrin ratios were performed in 60 subjects including 6 patients with documented EIF2B gene mutations, patients with other types of leukodystrophy, and patients with no leukodystrophy.All six patients with mutation proven eIF2B-related disease showed low to nearly undetectable amounts of asialotransferrin in their CSF when compared to 54 unaffected controls by CSF 2DG analyses in this study. eIF2B-like patients, with clinically similar presentations but no mutations in EIF2B1-5, were distinguished from patients with mutations in EIF2B1-5 by this biomarker. Patients with mutations in EIF2B1-5 had asialotransferrin/transferrin ratio levels significantly different from the group as a whole (p0.001). Using 8% asialotransferrin/transferrin ratio as a cutoff, this biomarker has a 100% sensitivity (95% CI = 52-100%) and 94% specificity (95% CI = 84-99%).Decreased asialotransferrin/transferrin ratio in the CSF of patients with eIF2B-related disorder is highly sensitive and specific. This rapid (48 hours) and inexpensive diagnostic tool for eIF2B-related disorders has the potential to identify patients with likely eIF2B-related disorder for mutation analysis. |
| Databáze: | OpenAIRE |
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