Useful For:
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.
Individual Antibody Follow-Up Testing: 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.
***Order Alert: Effective 01/23/2025, the Neuronal (V-G) K+ Channel Antibody (VGKC) test in this panel will be temporarily discontinued due to supply chain issues at Mayo. The component will be reported as "test not performed" and removed from profile interpretations until the issue is resolved. The expected duration is >30 days.***
Code | Name |
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RPNPEV | Paraneoplastic AutoAb Evaluation (Sendout) |
RANN1 | Anti Neuronal Nuclear Antibody 1 |
RANN2 | Anti Neuronal Nuclear Antibody 2 |
RANN3 | Anti Neuronal Nuclear Antibody 3 |
RAGNA1 | Anti Glial Nuclear Antibody 1 |
RPCA1 | Purkinje Cell Cytoplasmic Antibody 1 |
RPCA2 | Purkinje Cell Cytoplasmic Antibody 2 |
RPCATR | Purkinje Cell Cytoplasmic Antibody Tr |
RAMPHS | Amphiphysin Antibody |
RCRMP | CRMP 5 IgG |
RCCPQ | P/Q Type Calcium Channel Ab |
RNVGCK | Neuronal (V_G) K Channel Ab |
RPNINT | Paraneoplastic AutoAb Interp |
UW437 | UW Imm_Study Paraneoplastic AutoAb |
Panel and reflex tests include the following methods: Immunofluorescence assay (IFA), Cell-binding assay (CBA), Western blot (WB), Radioimmunoassay (RIA), Immunoblot (IB)
Reference Values:
Amphiphysin Antiibody: | Negative |
Anti-Glial Nuclear Antibody Type 1 (AGNA-1): | Negative |
Anti-Neuronal Nuclear Antibody Type 1 (ANNA-1): | Negative |
Anti-Neuronal Nuclear Antibody Type 2 (ANNA-2): | Negative |
Anti-Neuronal Nuclear Antibody Type 3 (ANNA-3): | Negative |
Collapsin Response-Mediator Protein-5 (CRMP-5) IgG: | Negative |
Neuronal (V-G) K+ Channel Antibody: | < or =0.02 nmol/L |
P/Q-Type Calcium Channel Antibody: | < or =0.02 nmol/L |
Purkinje Cell Cytoplasmic Antibody Type 1 (PCA-1): | Negative |
Purkinje Cell Cytoplasmic Antibody Type 2 (PCA-2): | Negative |
Purkinje Cell Cytoplasmic Antibody Type Tr (PCA-Tr): | Negative |
Note: Includes reference values for panel tests only.
Neuron-restricted patterns of IgG staining that do not fulfill criteria for amphiphysin, ANNA-1, ANNA-2, ANNA-3, AGNA-1, PCA-1, PCA-2, PCA-Tr, or CRMP-5-IgG may be reported as "unclassified antineuronal IgG." Complex patterns that include non-neuronal elements may be reported as "uninterpretable."
CRMP-5 Note: CRMP-5 titers lower than 1:240 are detectable by recombinant CRMP-5 Western blot analysis. CRMP-5 Western blot analysis will be done on request on stored serum (held 4 weeks). This supplemental testing is recommended in cases of chorea, vision loss, cranial neuropathy, and myelopathy.
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.
12 mL blood in RED TOP tubes or GOLD SSTs
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.
Centrifuge samples and transfer 4 mL serum (2 mL minimum) into the RPNPEV aliquot. If specimen volume allows, aliquot 1 mL serum into a separate plastic vial for Immunology (UW437). Prioritize the sendout test (RPNPEV).
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:
Stability: Refrigerated (preferred): 28 days; Frozen: 28 days; Ambient: 72 hours.
Reject Due To: Gross hemolysis, lipemia, icterus.
Sendout |
Mayo Clinic Laboratories
800-533-1710 200 First Street Southwest |
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