Test Code MDS2 Movement Disorder, Autoimmune/Paraneoplastic Evaluation, Serum
Ordering Guidance
Multiple neurological phenotype-specific autoimmune/paraneoplastic evaluations are available. For more information as well as phenotype-specific testing options, refer to Autoimmune Neurology Test Ordering Guide.
When more than one evaluation is ordered on the same order number the duplicate will be canceled.
For a list of antibodies performed with each evaluation, see Autoimmune Neurology Antibody Matrix.
This test should not be requested for patients who have recently received radioisotopes, therapeutically or diagnostically, because of potential assay interference. The specific waiting period before specimen collection will depend on the isotope administered, the dose given, and the clearance rate in the individual patient. Specimens will be screened for radioactivity prior to analysis. Radioactive specimens received in the laboratory will be held 1 week and assayed if sufficiently decayed or canceled if radioactivity remains.
Necessary Information
Provide the following information:
-Relevant clinical information
-Ordering provider name, phone number, mailing address, and e-mail address
Specimen Required
Patient Preparation: For optimal antibody detection, specimen collection is recommended before initiation of immunosuppressant medication or intravenous immunoglobulin treatment.
Supplies: Sarstedt Aliquot Tube 5 mL (T914)
Collection Container/Tube:
Preferred: Red top
Acceptable: Serum gel
Submission Container/Tube: Plastic vial
Specimen Volume: 4 mL
Collection Instructions: Centrifuge and aliquot serum into a plastic vial.
Forms
If not ordering electronically, complete, print, and send a Neurology Specialty Testing Client Test Request (T732) with the specimen.
Useful For
Evaluating patients with suspected paraneoplastic or other autoimmune movement disorders including patients with ataxia, brainstem encephalitis, chorea, dyskinesias, myoclonus, and parkinsonism using serum specimens
Profile Information
Test ID | Reporting Name | Available Separately | Always Performed |
---|---|---|---|
MDSI | Movement Disorder Interp, S | No | Yes |
AMPCS | AMPA-R Ab CBA, S | No | Yes |
AMPHS | Amphiphysin Ab, S | No | Yes |
AGN1S | Anti-Glial Nuclear Ab, Type 1 | No | Yes |
ANN1S | Anti-Neuronal Nuclear Ab, Type 1 | No | Yes |
ANN2S | Anti-Neuronal Nuclear Ab, Type 2 | No | Yes |
ANN3S | Anti-Neuronal Nuclear Ab, Type 3 | No | Yes |
APBIS | AP3B2 IFA, S | No | Yes |
CS2CS | CASPR2-IgG CBA, S | No | Yes |
CRMWS | CRMP-5-IgG Western Blot, S | Yes | Yes |
DPPCS | DPPX Ab CBA, S | No | Yes |
GABCS | GABA-B-R Ab CBA, S | No | Yes |
GD65S | GAD65 Ab Assay, S | Yes | Yes |
GFAIS | GFAP IFA, S | No | Yes |
GRFIS | GRAF1 IFA, S | No | Yes |
IG5CS | IgLON5 CBA, S | No | Yes |
ITPIS | ITPR1 IFA, S | No | Yes |
K11CS | KLHL11 Ab CBA, S | Yes | Yes |
LG1CS | LGI1-IgG CBA, S | No | Yes |
GL1IS | mGluR1 Ab IFA, S | No | Yes |
NCDIS | Neurochondrin IFA, S | No | Yes |
NIFIS | NIF IFA, S | No | Yes |
NMDCS | NMDA-R Ab CBA, S | No | Yes |
CCPQ | P/Q-Type Calcium Channel Ab | No | Yes |
PCABP | Purkinje Cell Cytoplasmic Ab Type 1 | No | Yes |
PCAB2 | Purkinje Cell Cytoplasmic Ab Type 2 | No | Yes |
PCATR | Purkinje Cell Cytoplasmic Ab Type Tr | No | Yes |
PDEIS | PDE10A Ab IFA, S | No | Yes |
SP5IS | Septin-5 IFA, S | No | Yes |
SP7IS | Septin-7 IFA, S | No | Yes |
T46IS | TRIM46 Ab IFA, S | No | Yes |
Reflex Tests
Test ID | Reporting Name | Available Separately | Always Performed |
---|---|---|---|
AGNBS | AGNA-1 Immunoblot, S | No | No |
AINCS | Alpha Internexin CBA, S | No | No |
AMPIS | AMPA-R Ab IF Titer Assay, S | No | No |
AMIBS | Amphiphysin Immunoblot, S | No | No |
AN1BS | ANNA-1 Immunoblot, S | No | No |
AN2BS | ANNA-2 Immunoblot, S | No | No |
DPPTS | DPPX Ab IFA Titer, S | No | No |
GABIS | GABA-B-R Ab IF Titer Assay, S | No | No |
GRFCS | GRAF1 CBA, S | No | No |
GRFTS | GRAF1 IFA Titer, S | No | No |
IG5TS | IgLON5 IFA Titer, S | No | No |
ITPCS | ITPR1 CBA, S | No | No |
ITPTS | ITPR1 IFA Titer, S | No | No |
GL1CS | mGluR1 Ab CBA, S | No | No |
GL1TS | mGluR1 Ab IFA Titer, S | No | No |
NFHCS | NIF Heavy Chain CBA, S | No | No |
NIFTS | NIF IFA Titer, S | No | No |
NFLCS | NIF Light Chain CBA, S | No | No |
NMDIS | NMDA-R Ab IF Titer Assay, S | No | No |
PC1BS | PCA-1 Immunoblot, S | No | No |
PCTBS | PCA-Tr Immunoblot, S | No | No |
K11TS | KLHL11 Ab IFA Titer, S | No | No |
AGNTS | AGNA-1 Titer, S | No | No |
AN1TS | ANNA-1 Titer, S | No | No |
AN2TS | ANNA-2 Titer, S | No | No |
AN3TS | ANNA-3 Titer, S | No | No |
APBCS | AP3B2 CBA, S | No | No |
APBTS | AP3B2 IFA Titer, S | No | No |
APHTS | Amphiphysin Ab Titer, S | No | No |
CRMTS | CRMP-5-IgG Titer, S | No | No |
GFACS | GFAP CBA, S | No | No |
GFATS | GFAP IFA Titer, S | No | No |
NCDCS | Neurochondrin CBA, S | No | No |
NCDTS | Neurochondrin IFA Titer, S | No | No |
PC1TS | PCA-1 Titer, S | No | No |
PC2TS | PCA-2 Titer, S | No | No |
PCTTS | PCA-Tr Titer, S | No | No |
SP5CS | Septin-5 CBA, S | No | No |
SP5TS | Septin-5 IFA Titer, S | No | No |
SP7CS | Septin-7 CBA, S | No | No |
SP7TS | Septin-7 IFA Titer, S | No | No |
PDETS | PDE10A Ab IFA Titer, S | No | No |
T46CS | TRIM46 Ab CBA, S | No | No |
T46TS | TRIM46 Ab IFA Titer, S | No | No |
Testing Algorithm
If the immunofluorescence assay (IFA) patterns suggest amphiphysin antibody, then the amphiphysin immunoblot and amphiphysin titer will be performed at an additional charge.
If the IFA pattern suggests antiglial nuclear antibody-1 (AGNA)-1, then the AGNA-1 immunoblot and AGNA-1 titer will be performed at an additional charge.
If the IFA pattern suggests antineuronal nuclear antibody type 1 (ANNA-1), then the ANNA-1 immunoblot, ANNA-1 titer, and ANNA-2 immunoblot will be performed at an additional charge.
If the IFA pattern suggests ANNA-2 antibody, then the ANNA-2 immunoblot, ANNA-2 titer, and ANNA-1 immunoblot will be performed at an additional charge.
If the client requests or the IFA pattern suggests ANNA-3 antibodies, then the ANNA-3 titer will be performed at an additional charge.
If the IFA pattern suggests adaptor protein 3 beta 2 (AP3B2) antibodies, then the AP3B2 cell-binding assay (CBA) and AP3B2 titer will be performed at an additional charge.
If the collapsin response-mediator protein-5 (CRMP-5)-IgG Western blot is positive, then the CRMP-5-IgG IFA titer will be performed at an additional charge.
If the IFA pattern suggests Purkinje cytoplasmic antibody type 1 (PCA-1), then the PCA-1 IB and PCA-1 titer will be performed at an additional charge.
If the IFA pattern suggests PCA-2 antibody, then the PCA-2 titer will be performed at an additional charge.
If the IFA pattern suggests PCA-Tr antibody, then the PCA-Tr IB and PCA-Tr titer will be performed at an additional charge.
If the IgLON5 antibody CBA result is positive, then IgLON5 antibody IFA titer will be performed at an additional charge.
If the IFA pattern suggests GTPase regulator associated with focal adhesion kinase-1 (GRAF1) antibody, then the GRAF1 CBA and GRAF1 antibody IFA titer will be performed at an additional charge.
If the IFA pattern suggests inositol 1,4,5-trisphosphate receptor (ITPR1) antibody, then the ITPR1 CBA and ITPR1 antibody IFA titer will be performed at an additional charge.
If the IFA pattern suggests alpha-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid (AMPA)-receptor antibody, then the AMPA-receptor antibody IFA titer will be performed at an additional charge.
If the dipeptidyl-peptidase-like protein-6 antibody (DPPX) antibody CBA result is positive, then the DPPX antibody IFA titer will be performed at an additional charge.
If the gamma-aminobutyric acid B (GABA-B)-receptor CBA result is positive, then the GABA-B-receptor antibody IFA titer will be performed at an additional charge.
If the IFA pattern suggests glial fibrillary acidic protein (GFAP) antibody, then the GFAP antibody CBA and GFAP antibody IFA titer will be performed at an additional charge.
If the IFA pattern suggests metabotropic glutamate receptor 1 (mGluR1) antibody, then the mGluR1 CBA and mGluR1 antibody IFA titer will be performed at an additional charge.
If the N-methyl-D-aspartate (NMDA)-receptor antibody CBA result is positive, then the NMDA-receptor antibody IFA titer is performed at an additional charge.
If the IFA pattern suggests neuronal intermediate filament (NIF) antibody, then the alpha internexin CBA, NIF heavy chain CBA, NIF light chain CBA, and NIF antibody IFA titer will be performed at an additional charge.
If the Kelch-like protein 11 (KLHL11) CBA result is reactive, then the KLHL11 antibody IFA titer will be performed at an additional charge.
If the IFA pattern suggests neurochondrin antibody, then the neurochondrin antibody CBA and neurochondrin titer will be performed at an additional charge.
If the IFA pattern suggests septin-5 antibody, then the septin-5 CBA and septin-5 titer will be performed at an additional charge.
If the IFA pattern suggests septin-7 antibody, then the septin-7 CBA and septin-7 titer are performed at an additional charge.
If the IFA pattern suggests tripartite motif-containing protein 46 (TRIM46) antibody, then the TRIM46 antibody CBA and TRIM46 IFA titer will be performed at an additional charge.
If the IFA pattern suggests phosphodiesterase 10A (PDE10A) antibody, then the PDE10A antibody IFA titer will be performed at an additional charge.
For more information see:
Autoimmune/Paraneoplastic Movement Disorder Evaluation Algorithm-Serum
Central Nervous System Demyelinating Disease Diagnostic Algorithm
Method Name
GRFIS, GRFTS, K11TS, AGN1S, AGNTS, AMPIS, AMPHS, APHTS, ANN1S, AN1TS, ANN2S, AN2TS, ANN3S, AN3TS, APBIS, APBTS, CRMTS, DPPTS, GABIS, GFAIS, GFATS, IG5TS, ITPIS, ITPTS, GL1IS, GL1TS, NCDIS, NCDTS, NIFIS, NIFTS, NMDIS, PCABP, PC1TS, PCAB2, PC2TS, PCATR, PCTTS, PDEIS, PDETS, SP7IS, SP7TS, SP5IS, SP5TS, T46IS, T46TS: Indirect Immunofluorescence Assay (IFA)
GRFCS, K11CS, AMPCS, APBCS, CS2CS, DPPCS, GABCS, GFACS, IG5CS, ITPCS, LG1CS, GL1CS, NCDCS, AINCS, NFLCS, NFHCS, NMDCS, SP7CS, SP5CS, T46CS: Cell Binding Assay (CBA)
CRMWS: Western Blot (WB)
AGNBS, AMIBS, AN1BS, AN2BS, PC1BS, PCTBS: Immunoblot (IB)
CCPQ, GD65S: Radioimmunoassay (RIA)
MDSI: Medical interpretation
Reporting Name
Movement, Autoimm/Paraneo, SSpecimen Type
SerumSpecimen Minimum Volume
3 mL
Specimen Stability Information
Specimen Type | Temperature | Time | Special Container |
---|---|---|---|
Serum | Refrigerated (preferred) | 28 days | |
Frozen | 28 days | ||
Ambient | 72 hours |
Reject Due To
Gross hemolysis | Reject |
Gross lipemia | Reject |
Gross icterus | Reject |
Clinical Information
Autoimmune movement disorders encapsulate a large and diverse group of neurologic disorders occurring either in isolation or accompanying more diffuse autoimmune encephalitic illnesses.
The full range of movement phenomena has been described, and, as they often occur in adults, many of the presentations can mimic neurodegenerative disorders, such as autoimmune chorea mimicking Huntington disease. Disorders may be ataxic, hypokinetic (parkinsonism), or hyperkinetic (myoclonus, chorea other dyskinetic disorders). Associated disorders may fall under the rubric of brainstem encephalitis.
The autoantibody targets are diverse and include neuronal surface proteins, such as leucine-rich, glioma-inactivated 1 (LGI1), as well as antibodies reactive with intracellular antigens (such as Purkinje cell cytoplasmic antibody type 1 [PCA-1]) that are markers of a central nervous system process mediated by CD8+ cytotoxic T cells.
In some instances (such as PCA-1 autoimmunity), antibodies detected in serum and cerebrospinal fluid can be indicative of a paraneoplastic cause and may direct the cancer search. In other instances (such as 65-kDa isoform of glutamic acid decarboxylase [GAD65] autoimmunity), a paraneoplastic cause is very unlikely, and early treatment with immunotherapy may promote improvement or recovery.
Reference Values
Test ID |
Reporting Name |
Methodology* |
Reference Value |
MDSI |
Movement Disorder Interp, S |
Medical interpretation |
Interpretive report |
AMPCS |
AMPA-R Ab CBA, S |
CBA |
Negative |
AMPHS |
Amphiphysin Ab, S |
IFA |
Negative |
AGN1S |
Anti-Glial Nuclear Ab, Type 1 |
IFA |
Negative |
ANN1S |
Anti-Neuronal Nuclear Ab, Type 1 |
IFA |
Negative |
ANN2S |
Anti-Neuronal Nuclear Ab, Type 2 |
IFA |
Negative |
ANN3S |
Anti-Neuronal Nuclear Ab, Type 3 |
IFA |
Negative |
APBIS |
AP3B2 IFA, S |
IFA |
Negative |
CS2CS |
CASPR2-IgG CBA, S |
CBA |
Negative |
CRMWS |
CRMP-5-IgG Western Blot, S |
WB |
Negative |
DPPCS |
DPPX Ab CBA, S |
CBA |
Negative |
GABCS |
GABA-B-R Ab CBA, S |
CBA |
Negative |
GD65S |
GAD65 Ab Assay, S |
RIA |
≤0.02 nmol/L Reference values apply to all ages. |
GFAIS |
GFAP IFA, S |
IFA |
Negative |
GRFIS |
GRAF1 IFA, S |
IFA |
Negative |
IG5CS |
IgLON5 CBA, S |
CBA |
Negative |
ITPIS |
ITPR1 IFA, S |
IFA |
Negative |
K11CS |
KLHL11 Ab CBA, S |
CBA |
Negative |
LG1CS |
LGI1-IgG CBA, S |
CBA |
Negative |
GL1IS |
mGluR1 Ab IFA, S |
IFA |
Negative |
NCDIS |
Neurochondrin IFA, S |
IFA |
Negative |
NIFIS |
NIF IFA, S |
IFA |
Negative |
NMDCS |
NMDA-R Ab CBA, S |
CBA |
Negative |
CCPQ |
P/Q-Type Calcium Channel Ab |
RIA |
≤0.02 nmol/L |
PCABP |
Purkinje Cell Cytoplasmic Ab Type 1 |
IFA |
Negative |
PCAB2 |
Purkinje Cell Cytoplasmic Ab Type 2 |
IFA |
Negative |
PCATR |
Purkinje Cell Cytoplasmic Ab Type Tr |
IFA |
Negative |
PDEIS |
PDE10A Ab IFA, S |
IFA |
Negative |
SP5IS |
Septin-5 IFA, S |
IFA |
Negative |
SP7IS |
Septin-7 IFA, S |
IFA |
Negative |
T46IS |
TRIM46 Ab IFA, S |
IFA |
Negative |
Reflex Information:
Test ID |
Reporting Name |
Methodology* |
Reference Value |
AGNBS |
AGNA-1 Immunoblot, S |
IB |
Negative |
AGNTS |
AGNA-1 Titer, S |
IFA |
<1:240 |
AINCS |
Alpha Internexin CBA, S |
CBA |
Negative |
AMPIS |
AMPA-R Ab IF Titer Assay, S |
IFA |
<1:240 |
AMIBS |
Amphiphysin Immunoblot, S |
IB |
Negative |
AN1BS |
ANNA-1 Immunoblot, S |
IB |
Negative |
AN1TS |
ANNA-1 Titer, S |
IFA |
<1:240 |
AN2BS |
ANNA-2 Immunoblot, S |
IB |
Negative |
AN2TS |
ANNA-2 Titer, S |
IFA |
<1:240 |
AN3TS |
ANNA-3 Titer, S |
IFA |
<1:240 |
APBCS |
AP3B2 CBA, S |
CBA |
Negative |
APBTS |
AP3B2 IFA Titer, S |
IFA |
<1:240 |
APHTS |
Amphiphysin Ab Titer, S |
IFA |
<1:240 |
CRMTS |
CRMP-5-IgG Titer, S |
IFA |
<1:240 |
DPPTS |
DPPX Ab IFA Titer, S |
IFA |
<1:240 |
GABIS |
GABA-B-R Ab IF Titer Assay, S |
IFA |
<1:240 |
GFACS |
GFAP CBA, S |
CBA |
Negative |
GFATS |
GFAP IFA Titer, S |
IFA |
<1:240 |
GRFCS |
GRAF1 CBA, S |
CBA |
Negative |
GRFTS |
GRAF1 IFA Titer, S |
IFA |
<1:240 |
IG5TS |
IgLON5 IFA Titer, S |
IFA |
<1:240 |
ITPCS |
ITPR1 CBA, S |
CBA |
Negative |
ITPTS |
ITPR1 IFA Titer, S |
IFA |
<1:240 |
K11TS |
KLHL11 Ab IFA Titer, S |
IFA |
<1:240 |
GL1CS |
mGluR1 Ab CBA, S |
CBA |
Negative |
GL1TS |
mGluR1 Ab IFA Titer, S |
IFA |
<1:240 |
NCDCS |
Neurochondrin CBA, S |
CBA |
Negative |
NCDTS |
Neurochondrin IFA Titer, S |
IFA |
<1:240 |
NFHCS |
NIF Heavy Chain CBA, S |
CBA |
Negative |
NIFTS |
NIF IFA Titer, S |
IFA |
<1:240 |
NFLCS |
NIF Light Chain CBA, S |
CBA |
Negative |
NMDIS |
NMDA-R Ab IF Titer Assay, S |
IFA |
<1:240 |
PC1BS |
PCA-1 Immunoblot, S |
IB |
Negative |
PC1TS |
PCA-1 Titer, S |
IFA |
<1:240 |
PC2TS |
PCA-2 Titer, S |
IFA |
<1:240 |
PCTBS |
PCA-Tr Immunoblot, S |
IB |
Negative |
PCTTS |
PCA-Tr Titer, S |
IFA |
<1:240 |
PDETS |
PDE10A Ab IFA Titer, S |
IFA |
<1:240 |
SP5CS |
Septin-5 CBA, S |
CBA |
Negative |
SP5TS |
Septin-5 IFA Titer, S |
IFA |
<1:240 |
SP7CS |
Septin-7 CBA, S |
CBA |
Negative |
SP7TS |
Septin-7 IFA Titer, S |
IFA |
<1:240 |
T46CS |
TRIM46 Ab CBA, S |
CBA |
Negative |
T46TS |
TRIM46 Ab IFA Titer, S |
IFA |
<1:240 |
*Methodology abbreviations:
Immunofluorescence assay (IFA)
Cell-binding assay (CBA)
Western blot (WB)
Radioimmunoassay (RIA)
Immunoblot (IB)
Neuron-restricted patterns of IgG staining that do not fulfill criteria for ANNA-1, ANNA-2, ANNA-3, CRMP-5-IgG, PCA-1, PCA-2, or PCA-Tr may be reported as "unclassified anti-neuronal IgG." Complex patterns that include nonneuronal elements may be reported as "uninterpretable."
Interpretation
A positive antibody result is consistent with a diagnosis of an autoimmune movement disorder.
A search for cancer may be indicated, depending on the antibody profile.
A trial of immune therapy may bring about improvement in neurological symptoms.
Cautions
A negative antibody test result does not exclude an autoimmune movement disorder.
Corticosteroid treatment prior to the serum collection may cause a false-negative result.
Intravenous immunoglobulin treatment prior to the serum collection may cause a false-positive result.
Method Description
Cell-Binding Assay:
Patient specimen is applied to a composite slide containing transfected and nontransfected HEK-293 cells. After incubation and washing, fluorescein-conjugated goat-antihuman IgG is applied to detect the presence of patient IgG binding.(Package insert: IIFT: Neurology Mosaics, Instructions for the indirect immunofluorescence test. EUROIMMUN; FA_112d-1_A_UK_C13, 02/2019)
Methodology for detecting Kelch-like protein 11 (KLHL11)-IgG uses an in-house developed cell binding assay (CBA) with confirmation by a tissue indirect immunofluorescence assay (IFA). The CBA utilizes HEK293 cells that are stably transfected with DNA encoding the KLHL11 protein that has been tagged with green fluorescent protein (GFP). Since KLHL11 is localized to cytoplasmic vesicles when ectopically expressed, cells will be fixed and permeabilized prior to exposure to patient sample. Patients that are positive for KLHL11-IgG will have human IgG bound to the transfected cells. Binding will colocalize with the GFP-tagged KLHL11 protein in cytoplasmic vesicles. Patient IgG will be detected using a tetramethylrhodamine conjugated anti-human secondary antibody. The negative samples will not bind to KLHL11-GFP in transfected cells. Performed in a 96 well plate format, the plates are scanned, and images saved using the ImageXpress Micro Confocal High-Content Imaging System (Molecular Devices). Images will be scored positive or negative.(Unpublished Mayo method)
Indirect Immunofluorescence Assay:
The patient's sample is tested by a standardized IFA that uses a composite frozen section of mouse cerebellum, kidney, and gut tissues. After incubation with sample and washing, fluorescein-conjugated goat-antihuman IgG is applied. Neuron-specific autoantibodies are identified by their characteristic fluorescence staining patterns. Samples that are scored positive for any neuronal nuclear or cytoplasmic autoantibody are titrated to an endpoint. Interference by coexisting non-neuron-specific autoantibodies can usually be eliminated by serologic absorption.(Honorat JA, Komorowski L, Josephs KA, et al. IgLON5 antibody: neurological accompaniments and outcomes in 20 patients. Neruol Neruoimmunol Neruoinflamm. 2017;4(5):e385. doi:10.1212/NXI.0000000000000385)
Radioimmunoassay:
(125)I-labeled recombinant human antigens or labeled receptors are incubated with patient specimen. After incubation, anti-human IgG is added to form an immunoprecipitate. The amount of (125)I-labeled antigen in the immunoprecipitate is measured using a gamma-counter. The amount of gamma emission in the precipitate is proportional to the amount of antigen-specific IgG in the specimen. Results are reported as units of precipitated antigen (nmol) per liter of patient sample.(Griesmann GE, Kryzer TJ, Lennon VA. Autoantibody profiles of myasthenia gravis and Lambert-Eaton myasthenic syndrome. In: Rose NR, Hamilton RG, et al, eds. Manual of Clinical and Laboratory Immunology. 6th ed. ASM Press; 2002:1005-1012; Jones AL, Flanagan EP, Pittock SJ, et al. Responses to and outcomes of treatment of autoimmune cerebellar ataxia in adults. JAMA Neurol. 2015;72[11]:1304-1312. doi:10.1001/jamaneurol.2015.2378)
Western Blot:
Neuronal antigens extracted aqueously from adult rat cerebellum, full-length recombinant human collapsin response-mediator protein-5 (CRMP-5), or full-length recombinant human amphiphysin protein is denatured, reduced, and separated by electrophoresis on 10% polyacrylamide gel. IgG is detected autoradiographically by enhanced chemiluminescence.(Yu Z, Kryzer TJ, Griesmann GE, et al. CRMP-5 neuronal autoantibody: marker of lung cancer and thymoma-related autoimmunity. Ann Neurol. 2001;49[2]:146-154; Dubey D, Jitprapaikulsan J, Bi H, et al. Amphiphysin-IgG autoimmune neuropathy: A recognizable clinicopathologic syndrome. Neurology. 2019;93[20]:e1873-e1880. doi:10.1212/WNL.0000000000008472)
Immunoblot:
All steps are performed at room temperature (18-28° C) utilizing the EUROBlot One instrument. Diluted patient serum (1:101) is added to test strips (strips containing recombinant antigen manufactured and purified using biochemical methods) in individual channels and incubated for 30 minutes. Positive specimens will bind to the purified recombinant antigen and negative specimens will not bind. Strips are washed to remove unbound serum antibodies and then incubated with anti-human IgG antibodies (alkaline phosphatase-labelled) for 30 minutes. The strips are again washed to remove unbound anti-human IgG antibodies and nitroblue tetrazolium chloride/5-bromo-4-chloro-3-indolylphosphate substrate is added. Alkaline phosphatase enzyme converts the soluble substrate into a colored insoluble product on the membrane to produce a black band. Strips are digitized via picture capture on the EUROBlot One instrument and evaluated with the EUROLineScan software.(O'Connor K, Waters P, Komorowski L, et al. GABAA receptor autoimmunity: A multicenter experience. Neurol Neuroimmunol Neuroinflamm. 2019;6[3]:e552. doi:10.1212/NXI.0000000000000552)
Day(s) Performed
Profile tests: Monday through Sunday; Reflex tests: Varies
Report Available
8 to 12 daysSpecimen Retention Time
28 daysPerforming Laboratory
Mayo Clinic Laboratories in RochesterCPT Code Information
86596
86255 x 26
84182
86341
0432U
84182 AGNBS (if appropriate)
86256 AGNTS (if appropriate)
86255 AINCS (if appropriate)
84182 AMIBS (if appropriate)
86256 AMPIS (if appropriate)
84182 AN1BS (if appropriate)
86256 AN1TS (if appropriate)
84182 AN2BS (if appropriate)
86256 AN2TS (if appropriate)
86256 AN3TS (if appropriate)
86255 APBCS (if appropriate)
86256 APBTS (if appropriate)
86256 APHTS (if appropriate)
86256 CRMTS (if appropriate)
86256 DPPTS (if appropriate)
86256 GABIS (if appropriate)
86255 GFACS (if appropriate)
86256 GFATS (if appropriate)
86255 GL1CS (if appropriate)
86256 GL1TS (if appropriate)
86255 GRFCS (if appropriate)
86256 GRFTS (if appropriate)
86256 IG5TS (if appropriate)
86255 ITPCS (if appropriate)
86256 ITPTS (if appropriate)
86256 K11TS (if appropriate)
86255 NCDCS (if appropriate)
86256 NCDTS (if appropriate)
86255 NFHCS (if appropriate)
86255 NFLCS (if appropriate)
86256 NIFTS (if appropriate)
86256 NMDIS (if appropriate)
84182 PC1BS (if appropriate)
86256 PC1TS (if appropriate)
86256 PC2TS (if appropriate)
84182 PCTBS (if appropriate)
86256 PCTTS (if appropriate)
86256 PDETS (if appropriate)
86255 SP5CS (if appropriate)
86256 SP5TS (if appropriate)
86255 SP7CS (if appropriate)
86256 SP7TS (if appropriate)
86255 T46CS (if appropriate)
86256 T46TS (if appropriate)
LOINC Code Information
Test ID | Test Order Name | Order LOINC Value |
---|---|---|
MDS2 | Movement, Autoimm/Paraneo, S | 94701-0 |
Result ID | Test Result Name | Result LOINC Value |
---|---|---|
61516 | NMDA-R Ab CBA, S | 93503-1 |
61518 | AMPA-R Ab CBA, S | 93489-3 |
61519 | GABA-B-R Ab CBA, S | 93428-1 |
606950 | IgLON5 CBA, S | 96478-3 |
610581 | KLHL11 Ab CBA, S | 99072-1 |
615867 | Neurochondrin IFA, S | 101452-1 |
615871 | Septin-5 IFA, S | 101460-4 |
615875 | Septin-7 IFA, S | 101465-3 |
615863 | AP3B2 IFA, S | 101907-4 |
616445 | TRIM46 Ab IFA, S | 103843-9 |
620068 | PDE10A Ab IFA, S | 103842-1 |
605155 | GFAP IFA, S | 94346-4 |
606952 | ITPR1 IFA, S | 96464-3 |
606964 | NIF IFA, S | 96486-6 |
606958 | GRAF1 IFA, S | 96471-8 |
64279 | LGI1-IgG CBA, S | 94287-0 |
64281 | CASPR2-IgG CBA, S | 94285-4 |
64933 | DPPX Ab CBA, S | 94676-4 |
64928 | mGluR1 Ab IFA, S | 94347-2 |
601998 | Movement Disorder Interp, S | 69048-7 |
89080 | AGNA-1, S | 84927-3 |
81722 | Amphiphysin Ab, S | 72327-0 |
80150 | ANNA-1, S | 33615-6 |
80776 | ANNA-2, S | 43187-4 |
83137 | ANNA-3, S | 43102-3 |
81185 | P/Q-Type Calcium Channel Ab | 94349-8 |
83107 | CRMP-5-IgG Western Blot, S | 47401-5 |
81596 | GAD65 Ab Assay, S | 30347-9 |
83138 | PCA-2, S | 84925-7 |
9477 | PCA-1, S | 84924-0 |
83076 | PCA-Tr, S | 84926-5 |
618903 | IFA Notes | 48767-8 |