Paraneoplastic Autoantibody Evaluation, CSF (Sendout)

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General Information

Lab Name
Lab Code
782
External Test Id
PAC1
Description

Useful For: Aids in the diagnosis of paraneoplastic neurological autoimmune disorders related to carcinoma of lung, breast, ovary, thymoma, or Hodgkin lymphoma in spinal fluid specimens.

For a complete list of tests and potential reflex tests included in this panel, refer to Mayo's algorithm linked below.

Synonyms
AGNA-1 CSF, Amphiphysin Ab CSF, ANNA-1 CSF, ANNA-2 CSF, ANNA-3 CSF, Anti-Glial Nuclear Ab, Anti-Neuronal Nuclear Ab Type 1, Anti-Neuronal Nuclear Ab Type 2 CSF, Anti-Neuronal Nuclear Ab Type 3 CSF, CRMP-5-IgG CSF, PAC1, PCA-1 CSF, PCA-2 CSF, PCA-Tr CSF, Purkinje Cell Cytoplasmic Ab Type 1 CSF, Purkinje Cell Cytoplasmic Ab Type 2 CSF, Purkinje Cell Cytoplasmic Ab Type Tr CSF, Type 1 CSF

Interpretation

Method

Panel Tests:

  • Indirect Immunofluorescence Assay (IFA): Amphiphysin Ab, AGNA-1, ANNA-1, ANNA-2, ANNA-3, CRMP-5-IgG, PCA-Tr, PCA-1, PCA-2.

Reflex Tests:

  • Indirect Immunofluorescence Assay (IFA): AGNA-1 Titer, ANNA-1 Titer, ANNA-2 Titer, ANNA-3 Titer, Amphiphysin Ab Titer, CRMP-5-IgG Titer, PCA-1 Titer, PCA-2 Titer, PCA-Tr Titer.
  • Western Blot (WB): CRMP-5-IgG Western Blot.
  • Immunoblot (IB): AGNA-1 Immunoblot, Amphiphysin Immunoblot, ANNA-1 Immunoblot, ANNA-2 Immunoblot, PCA-1 Immunoblot, PCA-Tr Immunoblot.
Ref. Range Notes

Reference Values:

(Panel tests only)

Amphiphysin Ab, CSF Negative
AGNA-1, CSF Negative
ANNA-1, CSF Negative
ANNA-2, CSF Negative
ANNA-3, CSF Negative
CRMP-5-IgG, CSF Negative
PCA-Tr, CSF Negative
PCA-1, CSF Negative
PCA-2, CSF Negative

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. Conversely, a positive autoantibody profile has 80% to 90% predictive value for a specific cancer. It is not uncommon for more than one paraneoplastic autoantibody to be detected, each predictive of the same cancer.

Guidelines

Ordering & Collection

Specimen Type
CSF
Collection

4 mL CSF in sterile vial

  • Preferred: Vial number 2.
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, icterus.

Quantity
requested: 4 mL CSF
minimum: 2 mL CSF

Processing

Processing

Refrigerate CSF in a sterile vial.

Login: SEND1-;REFRIG

  • RSNDT1: MAYO
  • RSTYP1: CSF
  • RTSRQ1: ;Paraneoplastic Autoantibody Evaluation (Mayo Test PAC1)

Sendouts:

  • Order Mayo test: PAC1.

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

Reject Due To: Gross hemolysis, lipemia, 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. Reflex tests: Varies. Report Available: 10-17 days.
Available STAT?
No

Billing & Coding

CPT codes
Billing Comments

Panel CPTs: 86255x9

Reflex testing may be performed at additional charge.

LOINC