[Contribution of autoantibodies to the diagnosis of peripheral neuropathies]

The identification of autoantibodies associated with dysimmune neuropathies was a major contribution to the characterisation of peripheral nerve disorders, the understanding of their pathophysiology, and the clinical diagnosis of neuropathies. This review focuses essentially on the interest of these antibodies in clinical practice. The methods used for their detection, their specificity and sensitivity is the first point to take into account. The second is the aim of the antibody detection, pathophysiological or diagnostic. The last is to adapt the search for antibodies to the clinical characteristics of the neuropathy. Antibodies directed to GM1, GQ1b and disyalilated gangliosides, and anti-MAG antibodies are very useful in the diagnosis of acute or chronic motor or sensory-motor neuropathies with or without monoclonal IgM. Anti-onconeural anti-Hu and anti-CV2/CRMP antibodies allow when they are detected the diagnosis of paraneoplastic neuropathies. Neuropathies also occur in the setting of systemic diseases. Detection of antibodies associated with these diseases such as ANCA, soluble nuclear antigens, gliadin, or mitochondry may be helpful in the diagnosis of neuropathies.