Useful For: Evaluating patients with suspected paraneoplastic or other autoimmune movement disorders including patients with ataxia, brainstem encephalitis, chorea, dyskinesias, myoclonus, and parkinsonism using spinal fluid 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 linked below.
Patient Preparation: For optimal antibody detection, specimen collection is recommended prior to initiation of immunosuppressant medication, or corticosteroid or intravenous immunoglobulin (IVIg) treatment.
Panel and reflex tests include the following methods: Immunofluorescence assay (IFA), Cell-binding assay (CBA), Western blot (WB), Radioimmunoassay (RIA), Immunoblot (IB)
Reference Ranges:
Alpha-amino-3-hydroxy-5-methyl-4-isoxazole Propionic Acid Receptor (AMPA-R) Antibody CBA, CSF: | Negative |
Amphiphysin Antibody, CSF: | Negative |
Anti-Glial Nuclear Antibody Type 1 (AGNA-1), CSF: | Negative |
Anti-Neuronal Nuclear Antibody Type 1 (ANNA-1), CSF: | Negative |
Anti-Neuronal Nuclear Antibody Type 2 (ANNA-2), CSF: | Negative |
Anti-Neuronal Nuclear Antibody Type 3 (ANNA-3), CSF: | Negative |
Adaptor Protein 3 Beta2 (AP3B2) Antibody IFA, CSF: | Negative |
Contactin-Associated Protein-Like-2 (CASPR2) IgG Antibody CBA, CSF: | Negative |
Collapsin Response-Mediator Protein-5 (CRMP-5) IgG Antibody WB, CSF: | Negative |
Dipeptidyl Aminopeptidase-Like Protein 6 (DPPX) Antibody CBA, CSF: | Negative |
Gamma Aminobutyric Acid Receptor Type B (GABA-B-R) Antibody CBA, CSF: | Negative |
Glutamic Acid Decarboxylase (GAD65) Antibody Assay, CSF: | < or =0.02 nmol/L |
Glial Fibrillary Acidic Protein (GFAP) Antibody IFA, CSF: | Negative |
GTPase regulator associated with focal adhesion kinase-1 (GRAF1) Antibody IFA, CSF: | Negative |
IgLON Family Member 5 (IgLON5) Antibody CBA, CSF: | Negative |
Inositol 1,4,5-trisphosphate receptor type 1 (ITPR1) Antibody IFA, CSF: | Negative |
Kelch-Like Protein 11 (KLHL11) Antibody CBA, CSF: | Negative |
Leucine-Rich Glioma Inactivated Protein-1 IgG (LGI1) Antibody CBA, CSF: | Negative |
Metabotropic Glutamate Receptor 1 (mGluR1) Antibody IFA, CSF: | Negative |
Neurochondrin Antibody IFA, CSF: | Negative |
Neuronal Intermediate Filament (NIF) Antibody IFA, CSF: | Negative |
N-methyl-D-Aspartate Receptor (NMDA-R) Antibody CBA, CSF: | Negative |
Purkinje Cell Cytoplasmic Antibody Type Tr, CSF (PCA-Tr): | Negative |
Purkinje Cell Cytoplasmic Antibody Type 1, CSF (PCA-1): | Negative |
Purkinje Cell Cytoplasmic Antibody Type 2, CSF (PCA-2): | Negative |
Phosphodiesterase 10A (PDE10A) Antibody IFA, CSF: | Negative |
Septin-5 Antibody IFA, CSF: | Negative |
Septin-7 Antibody IFA, CSF: | Negative |
Tripartite Motif-containing Protein 46 (TRIM46) Antibody IFA, CSF: | Negative |
Note: Includes reference values for panel tests only.
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 cerebrospinal fluid (CSF) collection may cause a false-negative result.
Intravenous immunoglobulin treatment prior to the CSF collection may cause a false-positive result.
Collect 4 mL CSF in a sterile vial.
Outside Laboratories: Refrigerate CSF in a sterile vial.
Stability: Refrigerated (preferred): 28 days; Frozen: 28 days; Ambient: 72 hours.
Reject Due To: Gross hemolysis, lipemia, or icterus.
Refrigerate CSF in a sterile vial.
Login: SEND1-;REFRIG
Sendouts:
Stability: Refrigerated (preferred): 28 days; Frozen: 28 days; Ambient: 72 hours.
Reject Due To: Gross hemolysis, lipemia, or icterus.
Sendout |
Mayo Clinic Laboratories
800-533-1710 200 First Street Southwest |
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Panel CPTs: 86255x26, 84182, 86341, 0432U
If indicated, reflex testing may be performed at additional charge.