Dementia Autoimmune Evaluation, CSF (Sendout)

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General Information

Lab Name
Lab Code
993
External Test Id
DMC2
Description

Useful For: Investigating new onset dementia and cognitive impairment plus 1 or more of the following accompaniments using cerebrospinal fluid specimens:

  • Rapid onset and progression
  • Fluctuating course
  • Psychiatric accompaniments (psychosis, hallucinations)
  • Movement disorder (myoclonus, tremor, dyskinesias
  • Headache
  • Autoimmune stigmata (personal history or family history or signs of diabetes mellitus, thyroid disorder, vitiligo, poliosis [premature graying], myasthenia gravis, rheumatoid arthritis, systemic lupus erythematosus)
  • Smoking history (20+ pack years) or other cancer risk factors
  • History of cancer
  • Inflammatory cerebrospinal fluid
  • Neuroimaging findings atypical for degenerative etiology

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.

Ordering Requirements: Pre-approved for HMC Neurology Clinic (NEUROH) and UW Multiple Sclerosis Clinic (MSCNW). Orders from other locations require Lab Medicine Resident (LMR) approval.

Synonyms
AMPA-R Ab CBA, Amphiphysin Ab, Anti-Glial Nuclear Ab, Anti-Neuronal Nuclear Ab, CASPR2-IgG, Cognitive decline, Cognitive impairment, Contactin-Associated Protein-Like-2 (CASPR2)-IgG, CRMP-5-IgG, DEMEC, dipeptidyl aminopeptidase-like protein 6, DMC2, DPPX, GABA-B-R Ab CBA, GFAP, Glutamic Acid Decarboxylase (GAD65), IgLON5, Leucine-Rich Glioma Inactivated Protein-1 IgG, LGI1-IgG, metabotropic glutamate receptor 1, mGluR1, NIF, NMDA-R Ab CBA, Purkinje Cell Cytoplasmic Ab Type 2, Purkinje Cell Cytoplasmic Ab Type Tr, Type 1, Type 2, Type 3

Interpretation

Method

Panel and reflex tests include the following methods: Indirect Immunofluorescence Assay (IFA), Cell Binding Assay (CBA), Radioimmunoassay (RIA), Immunoblot (IB), Western Blot (WB).

Ref. Range Notes

Reference Ranges: See report.

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:

  • Plasma membrane antibodies (N-methyl-D-aspartate [NMDA] receptor; 2-amino-3-[5-methyl-3-oxo-1,2- oxazol-4-yl] propanoic acid [AMPA] receptor; gamma-amino butyric acid [GABA]-B receptor). These autoantibodies are all potential effectors of dysfunction
  • Neuronal nuclear autoantibody type 1 (ANNA-1) or type 3 (ANNA-3)
  • Neuronal or muscle cytoplasmic antibodies (amphiphysin, Purkinje cell antibody-type 2 [PCA-2], collapsin response-mediator protein-5 neuronal [CRMP-5-IgG], or glutamic acid decarboxylase [GAD65] antibody).
Interferences and Limitations

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.

Guidelines

Ordering & Collection

Specimen Type
CSF
Collection

Collect 4mL CSF in a sterile vial

Approval Required
Pre-approved for HMC Neurology Clinic (NEUROH) and UW Multiple Sclerosis Clinic (MSCNW). Orders from other locations require Lab Medicine Resident approval.
Handling Instructions
Quantity
requested: 4 mL CSF
minimum: 2 mL CSF

Processing

Processing

Refrigerate CSF in a sterile vial.

Login: SEND1-;REFRIG

  • RSNDT1: MAYO
  • RSTYP1: CSF
  • RSTRQ1: ;Dementia Autoimmune Evaluation, CSF (Mayo Test DMC2)

Sendouts, order Mayo test: DMC2.

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

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

Performance

LIS Dept Code
Performing Location(s)
Sendout Mayo Clinic Laboratories
800-533-1710

200 First Street Southwest
Rochester, MN 55901
Frequency
Report Available: 8-11 days.
Available STAT?
No

Billing & Coding

CPT codes
Billing Comments

CPTs: 86255x19, 86341x1

Reflex testing may be performed at additional charge.

LOINC