Autoimmune Encephalitis Panel, CSF (Sendout)
General Information
- Lab Name
- Autoimmune Encephalitis Panel, CSF
- Lab Code
- RCAENP
- Epic Ordering
- Autoimmune Encephalitis Panel, CSF (Sendout)
- External Test Id
- ENC2
- Description
Test Information: Encephalitis is a debilitating neurologic condition caused by infectious and autoimmune conditions that result in inflammation of the brain parenchyma. The identification of autoantibodies may augment a diagnosis of autoimmune encephalitis, but is not required for the diagnosis or initiation of therapy. The most frequently identified antibodies target NMDA-R. We recommend ordering NMDA Receptor IgG Antibody with Reflex, CSF (Sendout) [RCNMDA] as first-line testing for autoimmune encephalitis prior to ordering this full panel.
Monitoring titers over time for these antibodies is not recommended; however, this recommendation is based on limited currently available literature.
Test Algorithm: Reflex testing may be performed at additional charge. Refer to Mayo's algorithm (linked below) for additional detail on tests and potential reflex tests included in this panel.
Ordering Guidance: Refer to Autoimmune Encephalitis Testing Recommendations or consult the Laboratory Medicine Resident on-call.
- The Mayo Antibody Prevalence in Epilepsy and Encephalopathy (APE²) Scorecard may be used to determine the likelihood of neural antibody positivity in patients with encephalopathy and/or seizures.
- Synonyms
- AGNA-1, AMPA-R Antibody CBA, Amphiphysin Antibody, ANNA-1, ANNA-2, ANNA-3, Anti-Glial Nuclear Antibody, Anti-Neuronal Nuclear Antibody Type 1, Anti-Neuronal Nuclear Antibody Type 2, Anti-Neuronal Nuclear Antibody Type 3, CASPR2 IgG CBA, Contactin-Associated Protein-Like-2 (CASPR2) IgG, CRMP-5 IgG, DPPX Ab IFA, ENC1, ENC2, Encephalopathy, Encephalopathy Autoimmune/Paraneoplastic Evaluation Spinal Fluid, GABA-B-R Antibody CBA, GAD65 Antibody Assay, GFAP IFA, Glutamic Acid Decarboxylase, IgLON5 IFA, Leucine-Rich Glioma Inactivated Protein-1 IgG, LGI1 IgG CBA, mGluR1 Ab IFA, Neurochondrin IFA, NIF IFA, NMDA-R Antibody CBA, PCA-1, PCA-2, PCA-Tr, Purkinje Cell Cytoplasmic Antibody Type 1, Purkinje Cell Cytoplasmic Antibody Type 2, Purkinje Cell Cytoplasmic Antibody Type Tr, Septin-7 IFA
- Components
-
Code Name RCENCI Encephalopathy, Interpretation, CSF RIFANT IFA Notes RCAMPA AMPA Receptor Ab CBA, CSF RCAMPH Amphiphysin Ab, CSF RCAGN1 Anti Glial Nuclear Ab, Type 1, CSF RCANA1 Anti Neuronal Nuclear Ab Type 1, CSF RCANN2 Anti Neuronal Nuclear Ab Type 2, CSF RCANN3 Anti Neuronal Nuclear Ab Type 3, CSF RCSPR2 CASPR2 IgG CBA, CSF RCRMP5 CRMP 5 IgG, CSF RCDPPX DPPX Ab IFA, CSF RCGABA GABA B Receptor Ab CBA, CSF RCGD65 GAD65 Ab Assay, CSF RCGFAP GFAP IFA, CSF RIG5IC IgLON5 IFA, CSF RCLGI1 LGI1 IgG CBA, CSF RCMGR1 mGluR1 Ab IFA, CSF RNCDIC Neurochondrin IFA, CSF RNIFIC NIF IFA, CSF RCNMDC NMDA Receptor Ab CBA, CSF RCPCAT Purkinje Cell Cytoplasmc Ab Type Tr, CSF RCPCY1 Purkinje Cell Cytoplasmic Ab Type 1, CSF RCPCA2 Purkinje Cell Cytoplasmic Ab Type 2, CSF RSP7IC Septin 7 IFA, CSF
Interpretation
- Method
ANNA-1, ANNA-2, ANNA-3, AGNA-1, PCA-1, PCA-2, PCA-Tr, Amphiphysin Ab, CRMP-5 IgG, DPPX Ab, GFAP, mGluR1 Ab, Neurochondrin Ab, Septin-7 Antibody: Indirect Immunofluorescence Assay (IFA)
AMPA-R Ab, GABA-B-R Ab, NMDA-R Ab CBA, LGI1-IgG CBA, CASPR2-IgG: Cell-Binding Assay (CBA)
GAD65 Ab: Immunoprecipitation Assay
- Reference Range
- See individual components
- Interferences and Limitations
This test is intended to be ordered for adult patients. If this test is ordered for a patient younger than 18 years of age, it will be canceled and automatically reordered by the laboratory as PCDEC/ Pediatric Autoimmune Encephalopathy/CNS Disorder Evaluation, Spinal Fluid. The pediatric autoimmune CNS disorders evaluation is part of an evolving approach to testing for autoimmune neurological disorders using phenotypic-specific evaluations that include multiple antibodies known for their disease association.
- Guidelines
Ordering & Collection
- Specimen Type
- CSF
- Collection
-
Collect 4 mL CSF and transfer to a sterile vial.
- Approval Required
- LMR approval is not required.
- Handling Instructions
Outside Laboratories: Refrigerate CSF in a sterile vial.
Stability: Refrigerated (preferred): 28 days; Frozen: 28 days; Ambient: 72 hours.
- Quantity
-
requested: 4 mL CSF
minimum: 2 mL CSF
Processing
- Processing
SPS: Use container code CSF4 to route this order in Sunquest SMART.
Refrigerate CSF in a sterile vial.
- Note: Sterile vial is preferred, but CSF samples transferred to a polypropylene aliquot will still be accepted by Mayo.
Sendouts:
- Order Mayo Test: ENC2.
- Interfaced: Yes.
Stability: Refrigerated (preferred): 28 days; Frozen: 28 days; Ambient: 72 hours.
Performance
- LIS Dept Code
- Sendouts Mayo Lab (RF) (MARF)
- Performing Location(s)
-
Sendout Mayo Clinic Laboratories
800-533-1710200 First Street Southwest
Rochester, MN 55901 - Frequency
- Performed: Monday - Sunday. Report Available: 5-10 days. Allow additional time for reflex testing, if performed.
- Available STAT?
- No
Billing & Coding
- CPT codes
- 86255x21, 86341
- Billing Comments
Reflex testing may be performed at additional charge.
- LOINC
- 94708-5
- Interfaced Order Code
- UOW4080