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.

Ordering Guidance: The Paraneoplastic Autoantibody Evaluation is not the recommended test for patients suspected of autoimmune neurological disorders. A comprehensive neurological phenotype-specific autoimmune/paraneoplastic evaluation (e.g. encephalopathy, movement disorders, myelopathy, axonal neuropathy, etc.) should be considered. For additional guidance, review the Autoimmune Encephalitis Testing Recommendations or consult the Laboratory Medicine Resident on-call.

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

Interpretation

Method

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

Ref. Range Notes

Reference Values:

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
Collapsin Response-Mediator Protein-5 (CRMP-5) IgG Antibody, 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

Note: Includes reference values for panel tests only.

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 through Sunday. Reflex tests: Varies. Report Available: 10-17 days.
Available STAT?
No

Billing & Coding

CPT codes
Billing Comments

CPTs: 86255x9

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