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

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General Information

Lab Name
Lab Code
1087
External Test Id
MDC2
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 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.

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, MDC2, 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, Parkinsonism, PCA-1, PCA-2, PCA-Tr, PDE10A IFA, Phosphodiesterase 10A Antibody, Purkinje Cell Cytoplasmc Antibody Type 1, Purkinje Cell Cytoplasmc Antibody Type 2, Purkinje Cell Cytoplasmc Antibody Type Tr, Septin-5 IFA, Septin-7 IFA, TRIM46 IFA, Tripartite Motif-containing Protein 46 Antibody
Components

Interpretation

Guidelines
Method

Panel and reflex tests include the following methods: Immunofluorescence assay (IFA), Cell-binding assay (CBA), Western blot (WB), Radioimmunoassay (RIA), Immunoblot (IB)

Reference Range
Ref. Range Notes

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.

Interferences and Limitations

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.

Ordering & Collection

Specimen Type
CSF
Collection

Collect 4 mL CSF in a sterile vial.

  • Preferred: Collection Vial Number 1
Approval Required
LMR approval is not required.
Handling Instructions

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.

Quantity
Requested: 4 mL CSF
Minimum: 2 mL CSF

Processing

Receiving Instructions

Refrigerate CSF in a sterile vial.

Login: SEND1-;REFRIG

  • RSNDT1: MAYO
  • RSTYP1: CSF
  • RTSRQ1: ;Movement Disorder, Autoimmune Paraneoplastic Evaluation, CSF (Mayo Test MDC2)

Sendouts:

  • Order Mayo Test: MDC2

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

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

Misc Sendout

Performance

Lab Department
Frequency
Performed: Monday - Sunday. Report Available: 8 - 12 days from sample receipt at performing lab.
Available STAT?
No
Performing Location(s)
Sendout Mayo Clinic Laboratories
800-533-1710

200 First Street Southwest
Rochester, MN 55901

Billing & Coding

Billing Comments

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

If indicated, reflex testing may be performed at additional charge.