Useful For: Investigating new onset dementia and cognitive impairment plus 1 or more of the following accompaniments using cerebrospinal fluid specimens:
Refer to Autoimmune Encephalitis Testing Recommendations for additional ordering guidance.
Test Algorithm: Reflex testing may be performed at additional charge. Refer to the Mayo algorithm below for a full list of tests and potential reflex tests included in this panel.
Panel and reflex tests include the following methods: Indirect Immunofluorescence Assay (IFA), Cell Binding Assay (CBA), Radioimmunoassay (RIA), Immunoblot (IB), Western Blot (WB).
Reference Values:
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 |
Contactin-Associated Protein-Like-2 (CASPR2) IgG Antibody CBA, CSF: | Negative |
Collapsin Response-Mediator Protein-5 (CRMP-5) IgG Antibody, 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 |
IgLON Family Member 5 (IgLON5) Antibody CBA, CSF: | Negative |
Leucine-Rich Glioma Inactivated Protein-1 IgG (LGI1) Antibody CBA, CSF: | Negative |
Neurochondrin IFA, CSF: | Negative |
Metabotropic Glutamate Receptor 1 (mGluR1) 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 Cytoplasmc Antibody Type Tr, CSF: | Negative |
Purkinje Cell Cytoplasmic Antibody Type 2, CSF: | Negative |
Phosphodiesterase 10A (PDE10A) 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-2, or PCA-Tr may be reported as "unclassified anti-neuronal IgG." Complex patterns that include nonneuronal elements may be reported as "uninterpretable."
CRMP-5 Note: CRMP-5 titers lower than 1:2 are detectable by recombinant CRMP-5 Western blot analysis. CRMP-5 Western blot analysis will be done on request on stored spinal fluid (held 4 weeks). This supplemental testing is recommended in cases of chorea, vision loss, cranial neuropathy, and myelopathy.
Intepretation: Antibodies specific for neuronal, glial, or muscle proteins are valuable serological markers of autoimmune epilepsy and of a patient's immune response to cancer. These autoantibodies are not found in healthy subjects and are usually accompanied by subacute neurological symptoms and signs. It is not uncommon for more than 1 of the following autoantibodies to be detected in patients with autoimmune dementia:
Cautions:
Negative results do not exclude autoimmune dementia or cancer.
This evaluation does not detect Ma1 or Ma2 antibodies (also known as MaTa). Ma2 antibody has been described in patients with brainstem and limbic encephalitis in the context of testicular germ cell neoplasms. Scrotal ultrasound is advisable in men who present with unexplained subacute encephalitis.
Collect 4mL CSF in a sterile vial
Outside Laboratories: Refrigerate 4 mL (2 mL minimum) 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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CPTs: 86255x21, 86341x1