Paraneoplastic AutoAb Evaluation (Sendout)

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General Information

Lab Name
Paraneoplastic Autoantibody Evaluation, Serum (Sendout)
Lab Code
RPNPV
Epic Ordering
Paraneoplastic Autoantibody Evaluation, Serum (Sendout)
External Test Id
PAVAL
Description

Useful For:

  • Serological evaluation of patients who present with a subacute neurological disorder of undetermined etiology, especially those with known risk factors for cancer
  • Directing a focused search for cancer
  • Investigating neurological symptoms that appear in the course of, or after, cancer therapy, and are not explainable by metastasis
  • Differentiating autoimmune neuropathies from neurotoxic effects of chemotherapy
  • Monitoring the immune response of seropositive patients in the course of cancer therapy
  • Detecting early evidence of cancer recurrence in previously seropositive patients

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

Ordering Note: Individual antibody tests within the Paraneoplastic Autoantibody Evaluation are available for patients who have previously tested positive for those antibodies within the past five years at a Mayo laboratory. Refer to Mayo test: Neuroimmunology Antibody Follow-up, Serum.

Synonyms
AGNA-1, Amphiphysin Ab, ANNA-1, ANNA-2, ANNA-3, Anti Glial Nuclear Ab 1, Anti Neuronal Nuclear Ab 1, Anti Neuronal Nuclear Ab 2, Anti Neuronal Nuclear Ab 3, CRMP-5 IgG, P/Q Type Calcium Channel Ab, PAVAL, PCA-1, PCA-2, PCA-Tr, Purkinje Cell Cytoplasmic Ab Type 1, Purkinje Cell Cytoplasmic Ab Type 2, Purkinje Cell Cytoplasmic Ab Type Tr
Components

Interpretation

Method

Panel Tests:

  • Indirect Immunofluorescence Assay (IFA): Amphiphysin Ab, Anti-Glial Nuclear Ab Type 1,
    Anti-Neuronal Nuclear Ab Type 1, Anti-Neuronal Nuclear Ab Type 2, Anti-Neuronal Nuclear Ab Type 3, CRMP-5-IgG, Purkinje Cell Cytoplasmic Ab Type 1, Purkinje Cell Cytoplasmic Ab Type 2, Purkinje Cell Cytoplasmic Ab Type Tr.
  • Radioimmunoassay (RIA): Neuronal (V-G) K+ Channel Ab, P/Q-Type Calcium Channel Ab.

Reflex Tests:

  • Indirect Immunofluorescence Assay (IFA): AGNA-1 Titer, Amphiphysin Ab Titer, ANNA-1 Titer, ANNA-3 Titer, CRMP-5-IgG Titer, PCA-1 Titer, PCA-2 Titer, PCA-Tr Titer, ANNA-2 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.
  • Cell-Binding Assay (CBA): CASPR2-IgG CBA, LGI1-IgG CBA.
Reference Range
See individual components
Ref. Range Notes

Reference Ranges:

(Panel tests only)

Amphiphysin Ab, Serum Negative
AGNA-1, Serum Negative
ANNA-1, Serum Negative
ANNA-2, Serum Negative
ANNA-3, Serum Negative
CRMP-5-IgG, Serum Negative
Neuronal (V-G) K+ Channel Ab, Serum < or =0.02 nmol/L
P/Q-Type Calcium Channel Ab, Serum < or =0.02 nmol/L
PCA-1, Serum Negative
PCA-2, Serum Negative
PCA-Tr, Serum 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 symptoms and signs. 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
Blood
Collection

12 mL blood in RED TOP tubes or GOLD SSTs

Handling Instructions

Outside Laboratories: Centrifuge sample and transfer serum into a separate plastic vial. Refrigerate serum.

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

Reject Due To: Gross hemolysis, lipemia, icterus.

Quantity
requested: 4 mL serum + 1 mL for UW437
minimum: 2 mL serum

Processing

Processing

Centrifuge samples. If specimen volume allows, aliquot 1mL serum into a separate plastic vial for Immunology (UW437) and the remaining serum into a plastic vial for the Sendout test (RPNPEV). Prioritize the Sendout test.

  • RPNPEV: Refrigerate serum.
  • UW437: Freeze serum at -20°C.

If individual antibodies are requested (with a previous positive result within the last 5 years at Mayo), refer to separate test guide #982 (Neuroimmunology Follow-up, PNEFS).

Sendouts:

  • Order Mayo Test: PAVAL.

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
83519, 86256x9, 86596
LOINC
43104-9
Interfaced Order Code
UOW3348