Useful For:
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 (IVIg) 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.
Panel and reflex tests include the following methods: Immunofluorescence assay (IFA), Cell-binding assay (CBA), Western blot (WB), Immunoblot (IB)
Reference Values:
Anti-Glial Nuclear Antibody Type 1 (AGNA-1): | Negative |
Amphiphysin Antibody: | Negative |
Anti-Neuronal Nuclear Antibody Type 1 (ANNA-1): | Negative |
Anti-Neuronal Nuclear Antibody Type 3 (ANNA-3): | Negative |
Adaptor Protein 3 Beta2 (AP3B2) Antibody IFA: | Negative |
Collapsin Response-Mediator Protein-5 (CRMP-5) IgG Western Blot: | Negative |
Contactin-Associated Protein-Like-2 (CASPR2) IgG Antibody CBA: | Negative |
IgLON Family Member 5 Antibody (IgLON5) CBA: | Negative |
Leucine-Rich Glioma Inactivated Protein-1 (LGI1) IgG Antibody CBA: | Negative |
Neuronal Intermediate Filament (NIF) Antibody IFA: | Negative |
Purkinje Cell Cytoplasmic Antibody Type 2 (PCA-2): | Negative |
Purkinje Cell Cytoplasmic Antibody Type 1 (PCA-1): | Negative |
Glial Fibrillary Acidic Protein (GFAP) Antibody IFA: | 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, CRMP-5-IgG, PCA-1, or PCA-2 may be reported as "unclassified anti-neuronal IgG." Complex patterns that include nonneuronal elements may be reported as "uninterpretable."
Interpretation: Antibodies directed at onconeural proteins shared by neurons, glia, muscle, and certain cancers are valuable serological markers of a patient's immune response to cancer. They are not found in healthy subjects and are usually accompanied by subacute neurological signs and symptoms. Several autoantibodies have a syndromic association, but no autoantibody predicts a specific neurological syndrome. More than one paraneoplastic autoantibody may be detected and associated with specific cancers.
Cautions:
Negative results do not exclude the possibility of a cancer diagnosis.
Intravenous immunoglobulin treatment prior to the serum collection may cause a false-positive result.
12 mL blood in RED TOP tubes or GOLD SSTs
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.
Centrifuge sample and transfer serum to a separate plastic vial. Refrigerate serum.
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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CPTs: 86255x12, 84182