Movement Disorder, Autoimmune/Paraneoplastic Evaluation, Serum (Sendout)

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General Information

Lab Name
Lab Code
1086
External Test Id
MDS2
Description

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. Refer to Autoimmune Encephalitis Testing Recommendations for additional ordering guidance.

Testing Algorithm: Reflex testing may be performed at additional charge. Refer to Mayo's algorithm below.

Patient Preparation:

  • For optimal antibody detection, specimen collection is recommended prior to initiation of immunosuppressant medication or intravenous immunoglobulin treatment.
  • 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.

Ordering Requirements: Laboratory Medicine Resident (LMR) approval is required.

Synonyms
Adaptor Protein 3 Beta2 Antibody, AGNA-1, AMPA-R Antibody CBA, Amphiphysin Antibody, ANNA-1, ANNA-2, ANNA-3, Anti-Glial Nuclear Antibody Type 1, Anti-Neuronal Nuclear Antibody Type 1, Anti-Neuronal Nuclear Antibody Type 2, Anti-Neuronal Nuclear Antibody Type 3, AP3B2 IFA, Ataxia, Brainstem encephalitis, CASPR2 IgG CBA, Chorea, Collapsin Response-Mediator Protein-5 IgG Western Blot, Contactin-Associated Protein-Like-2 IgG, CRMP-5 IgG Western Blot, Dipeptidyl Aminopeptidase-Like Protein 6, DPPX Antibody CBA, Dyskinesias, GABA-B-R Antibody CBA, GAD65 Antibody Assay, Gamma Aminobutyric Acid Receptor Type B, GFAP IFA, Glial Fibrillary Acidic Protein Antibody, Glutamic Acid Decarboxylase Antibody, GRAF1 IFA, GTPase regulator associated with focal adhesion kinase-1, IgLON Family Member 5 Antibody, IgLON5 CBA, ITPR1 IFA, Kelch-Like Protein 11 Antibody, KLHL11 Ab CBA, Leucine-Rich Glioma Inactivated Protein-1 IgG, LGI1 IgG CBA, MDS2, Metabotropic Glutamate Receptor 1 Antibody, mGluR1 Ab IFA, Movement Disorder Autoimmune Paraneoplastic Evaluation, Myoclonus, N-methyl-D-Aspartate Receptor Antibody, Neurochondrin IFA, Neuronal Intermediate Filament Antibody, NIF IFA, NMDA-R Ab CBA, P/Q-Type Calcium Channel Antibody, Parkinsonism, PCA-1, PCA-2, PCA-Tr, PDE10A Ab IFA, Phosphodiesterase 10A Antibody, Purkinje Cell Cytoplasmic Antibody Type 1, Purkinje Cell Cytoplasmic Antibody Type 2, Purkinje Cell Cytoplasmic Antibody Type Tr, Septin-5 IFA, Septin-7 IFA, TRIM46 Ab IFA, Tripartite Motif-containing Protein 46 Antibody

Interpretation

Method

Panel and reflex tests include the following methods: Indirect Immunofluorescence Assay (IFA), Cell Binding Assay (CBA), Radioimmunoassay (RIA), Immunoblot (IB), Western Blot (WB)

Ref. Range Notes

Reference Values:

Alpha-amino-3-hydroxy-5-methyl-4-isoxazole Propionic Acid Receptor (AMPA-R) Antibody CBA: Negative
Amphiphysin Antibody: Negative
Anti-Glial Nuclear Antibody Type 1 (AGNA-1): Negative
Anti-Neuronal Nuclear Antibody Type 1 (ANNA-1): Negative
Anti-Neuronal Nuclear Antibody Type 2 (ANNA-2): Negative
Anti-Neuronal Nuclear Antibody Type 3 (ANNA-3): Negative
Adaptor Protein 3 Beta2 (AP3B2) Antibody IFA: Negative
Contactin-Associated Protein-Like-2 (CASPR2) IgG Antibody CBA: Negative
Collapsin Response-Mediator Protein-5 (CRMP-5) IgG WB: Negative
Dipeptidyl Aminopeptidase-Like Protein 6 (DPPX) Antibody CBA: Negative
Gamma Aminobutyric Acid Receptor Type B (GABA-B-R) Antibody CBA: Negative
Glutamic Acid Decarboxylase (GAD65) Antibody Assay: < or =0.02 nmol/L
Glial Fibrillary Acidic Protein (GFAP) Antibody IFA: Negative
GTPase regulator associated with focal adhesion kinase-1 (GRAF1) IFA: Negative
IgLON Family Member 5 (IgLON5) Antibody CBA: Negative
Inositol 1,4,5-trisphosphate receptor type 1 (ITPR1) Antibody IFA: Negative
Kelch-Like Protein 11 (KLHL11) Antibody CBA: Negative
Leucine-Rich Glioma Inactivated Protein-1 IgG (LGI1) Antibody CBA: Negative
Metabotropic Glutamate Receptor 1 (mGluR1) Antibody IFA: Negative
Neurochondrin Antibody IFA: Negative
Neuronal Intermediate Filament (NIF) Antibody IFA: Negative
N-methyl-D-Aspartate Receptor (NMDA-R) Antibody CBA: Negative
P/Q-Type Calcium Channel Antibody: Negative
Purkinje Cell Cytoplasmic Antibody Type Tr (PCA-Tr): Negative
Purkinje Cell Cytoplasmic Antibody Type 1 (PCA-1): Negative
Purkinje Cell Cytoplasmic Antibody Type 2 (PCA-2): Negative
Phosphodiesterase 10A (PDE10A) Antibody IFA: Negative
Septin-5 Antibody IFA: Negative
Septin-7 Antibody IFA: Negative
Tripartite Motif-containing Protein 46 (TRIM46) Antibody IFA: Negative

Note: Includes reference values for panel tests only.

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.

Interferences and Limitations

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 (IVIg) treatment prior to the serum collection may cause a false-positive result.

Guidelines

Ordering & Collection

Specimen Type
Blood
Collection

Collect 12 mL blood in RED TOP tube or GOLD SST

Approval Required
Laboratory Medicine Resident (LMR) approval is required.
Handling Instructions

Outside Laboratories: Centrifuge sample and transfer serum to a separate plastic vial. Refrigerate serum.

Stability: Refrigerated (preferred): 28 days; Frozen: 28 days; Ambient: 72 hours.

Reject Due To: Gross hemolysis, lipemia, or icterus.

Quantity
requested: 4 mL serum
minimum: 3 mL serum

Processing

Processing

Centrifuge sample and transfer serum to a separate plastic vial. Refrigerate serum.

Login: SEND1-;REFRIG

  • RSNDT1: MAYO
  • RSTYP1: SRM
  • RTSRQ1: ;Movement Disorder, Autoimmune Paraneoplastic Eval, Serum (Mayo Test MDS2)

Sendouts:

  • Order Mayo Test: MDS2.

Stability: Refrigerated (preferred): 28 days; Frozen: 28 days; Ambient: 72 hours.

Reject Due To: Gross hemolysis, lipemia, or icterus.

Performance

LIS Dept Code
Performing Location(s)
Sendout Mayo Clinic Laboratories
800-533-1710

200 First Street Southwest
Rochester, MN 55901

Frequency
Performed: Monday - Sunday. Report Available: 8 - 12 days.
Available STAT?
No

Billing & Coding

CPT codes
Billing Comments

CPTs: 86596, 86255x26, 84182, 86341, 0432U

  • Note: Includes panel tests only. Reflex testing may be added at additional charge.
LOINC