Test ID AIAES Axonal Neuropathy, Autoimmune/Paraneoplastic Evaluation, Serum
Ordering Guidance
Multiple neuroimmunology profile tests are available. For testing that is performed with each profile, see Autoimmune Neurology Antibody Matrix.
Necessary Information
Provide the following information:
-Relevant clinical information
-Ordering provider name, phone number, mailing address, and e-mail address
Specimen Required
Patient Preparation:
1. For optimal antibody detection, specimen collection is recommended prior to initiation of immunosuppressant medication or intravenous immunoglobulin (IVIg) treatment.
2. This test should not be requested for patients who have recently received radioisotopes, therapeutically or diagnostically, because of potential assay interference. The specific waiting period before specimen collection will depend on the isotope administered, the dose given, and the clearance rate in the individual patient. Specimens will be screened for radioactivity prior to analysis. Radioactive specimens received in the laboratory will be held 1 week and assayed if sufficiently decayed or canceled if radioactivity remains.
Supplies: Sarstedt Aliquot Tube, 5 mL (T914)
Collection Container/Tube:
Preferred: Red top
Acceptable: Serum gel
Submission Container/Tube: Plastic vial
Specimen Volume: 4 mL
Collection Instructions: Centrifuge and aliquot serum into a plastic vial.
Useful For
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 during, or after, cancer therapy, and are not explainable by metastasis
Differentiating autoimmune neuropathies from neurotoxic effects of chemotherapy
Detecting early evidence of cancer recurrence in previously seropositive patients
Profile Information
Test ID | Reporting Name | Available Separately | Always Performed |
---|---|---|---|
AIAEI | Autoimmune Axonal Interp, S | No | Yes |
AMPHS | Amphiphysin Ab, S | No | Yes |
ANN1S | Anti-Neuronal Nuclear Ab, Type 1 | No | Yes |
ANN3S | Anti-Neuronal Nuclear Ab, Type 3 | No | Yes |
AGN1S | Anti-Glial Nuclear Ab, Type 1 | No | Yes |
APBIS | AP3B2 IFA, S | No | Yes |
CS2CS | CASPR2-IgG CBA, S | No | Yes |
CRMWS | CRMP-5-IgG Western Blot, S | Yes | Yes |
GFAIS | GFAP IFA, S | No | Yes |
LG1CS | LGI1-IgG CBA, S | No | Yes |
NIFIS | NIF IFA, S | No | Yes |
PCABP | Purkinje Cell Cytoplasmic Ab Type 1 | No | Yes |
PCAB2 | Purkinje Cell Cytoplasmic Ab Type 2 | No | Yes |
Reflex Tests
Test ID | Reporting Name | Available Separately | Always Performed |
---|---|---|---|
AGNBS | AGNA-1 Immunoblot, S | No | No |
AINCS | Alpha Internexin CBA, S | No | No |
AMIBS | Amphiphysin Immunoblot, S | No | No |
AN1BS | ANNA-1 Immunoblot, S | No | No |
AN1TS | ANNA-1 Titer, S | No | No |
AN2BS | ANNA-2 Immunoblot, S | No | No |
AN3TS | ANNA-3 Titer, S | No | No |
APBCS | AP3B2 CBA, S | No | No |
APBTS | AP3B2 IFA Titer, S | No | No |
APHTS | Amphiphysin Ab Titer, S | No | No |
CRMTS | CRMP-5-IgG Titer, S | No | No |
GFACS | GFAP CBA, S | No | No |
GFATS | GFAP IFA Titer, S | No | No |
NFHCS | NIF Heavy Chain CBA, S | No | No |
NFLCS | NIF Light Chain CBA, S | No | No |
NIFTS | NIF IFA Titer, S | No | No |
PC1BS | PCA-1 Immunoblot, S | No | No |
PC1TS | PCA-1 Titer, S | No | No |
PC2TS | PCA-2 Titer, S | No | No |
AGNTS | AGNA-1 Titer, S | No | No |
Testing Algorithm
If the indirect immunofluorescence assay (IFA) patterns suggest antiglial nuclear antibody-1 (AGNA-1), then AGNA-1 antibody IFA titer and AGNA-1 antibody immunoblot will be performed at an additional charge.
If the IFA patterns suggest antineuronal nuclear antibody type 1 (ANNA-1), then ANNA-1 IFA titer, ANNA-1 immunoblot, and ANNA-2 immunoblot will be performed at an additional charge.
If the IFA pattern suggests ANNA-3 antibody, then ANNA-3 IFA titer will be performed at an additional charge.
If the IFA pattern suggests Purkinje cytoplasmic antibody type 1 (PCA-1), then PCA-1 antibody IFA titer and PCA-1 antibody immunoblot will be performed at an additional charge.
If the IFA pattern suggests PCA-2 antibody, then PCA-2 antibody IFA titer will be performed at an additional charge.
If the IFA patterns suggest amphiphysin antibody, then amphiphysin antibody IFA titer and amphiphysin antibody immunoblot will be performed at an additional charge.
If the IFA pattern suggests glial fibrillary acidic protein (GFAP) antibody, then GFAP antibody cell binding assay (CBA) and GFAP antibody IFA titer will be performed at an additional charge.
If the collapsin response-mediator protein-5 (CRMP-5)-IgG antibody Western blot is positive, then CRMP-5-IgG antibody IF titer will be performed at an additional charge.
If the IFA pattern suggests adaptor protein 3 beta 2 (AP3B2) antibody, then AP3B2 antibody IFA titer and AP3B2 antibody CBA will be performed at an additional charge.
If the IFA pattern suggests neuronal intermediate filament (NIF) antibody, then alpha internexin CBA NIF heavy chain CBA, NIF light chain CBA, and NIF IFA titer will be performed at an additional charge.
For more information see Autoimmune/Paraneoplastic Axonal Neuropathy Evaluation Algorithm.
Method Name
APBCS, CS2CS, LG1CS, AINCS, NFLCS, NFHCS, GFACS: Cell Binding Assay (CBA)
AGN1S, AGNTS, AMPHS, APHTS, ANN1S, AN1TS, ANN3S, AN3TS, APBIS, APBTS, NIFIS, NIFTS, PCABP, PCAB2, PC1TS, PC2TS, GFAIS, GFATS, CRMTS: Indirect Immunofluorescence Assay (IFA)
CRMWS; Western Blot (WB)
AGNBS, AMIBS, AN1BS, PC1BS, AN2BS: Immunoblot (IB)
Reporting Name
Axonal, Autoimm/Paraneo, SSpecimen Type
SerumSpecimen Minimum Volume
2 mL
Specimen Stability Information
Specimen Type | Temperature | Time | Special Container |
---|---|---|---|
Serum | Refrigerated (preferred) | 28 days | |
Frozen | 28 days | ||
Ambient | 72 hours |
Reference Values
Test ID |
Reporting name |
Methodology |
Reference value |
AIAEI |
Autoimmune Axonal Interp, S |
Medical interpretation |
NA |
AGN1S |
Anti-Glial Nuclear Ab, Type 1 |
IFA |
Negative |
AMPHS |
Amphiphysin Ab, S |
IFA |
Negative |
ANN1S |
ANNA-1, S |
IFA |
Negative |
ANN3S |
ANNA-3, S |
IFA |
Negative |
APBIS |
AP3B2 IFA, S |
IFA |
Negative |
CRMWS |
CRMP-5-IgG Western Blot, S |
WB |
Negative |
CS2CS |
CASPR2-IgG CBA, S |
CBA |
Negative |
LG1CS |
LGI1-IgG CBA, S |
CBA |
Negative |
NIFIS |
NIF IFA, S |
IFA |
Negative |
PCAB2 |
PCA-2, S |
IFA |
Negative |
PCABP |
PCA-1, S |
IFA |
Negative |
GFAIS |
GFAP IFA, S |
IFA |
Negative |
Reflex Information:
Test ID |
Reporting name |
Methodology |
Reference value |
AGNBS |
AGNA-1 Immunoblot, S |
IB |
Negative |
AGNTS |
AGNA-1 Titer, S |
IFA |
<1:240 |
AINCS |
Alpha Internexin CBA, S |
CBA |
Negative |
AMIBS |
Amphiphysin Immunoblot, S |
IB |
Negative |
AN1BS |
ANNA-1 Immunoblot, S |
IB |
Negative |
AN1TS |
ANNA-1 Titer, S |
IFA |
<1:240 |
AN2BS |
ANNA-2 Immunoblot, S |
IB |
Negative |
AN3TS |
ANNA-3 Titer, S |
IFA |
<1:240 |
APBCS |
AP3B2 CBA, S |
CBA |
Negative |
APBTS |
AP3B2 IFA Titer, S |
IFA |
<1:240 |
APHTS |
Amphiphysin Ab Titer, S |
IFA |
<1:240 |
CRMTS |
CRMP-5-IgG Titer, S |
IFA |
<1:240 |
GFACS |
GFAP CBA, S |
CBA |
Negative |
GFATS |
GFAP IFA Titer, S |
IFA |
<1:240 |
NFHCS |
NIF Heavy Chain CBA, S |
CBA |
Negative |
NFLCS |
NIF Light Chain CBA, S |
CBA |
Negative |
NIFTS |
NIF IFA Titer, S |
IFA |
<1:240 |
PC1BS |
PCA-1 Immunoblot, S |
IB |
Negative |
PC1TS |
PCA-1 Titer, S |
IFA |
<1:240 |
PC2TS |
PCA-2 Titer, S |
IFA |
<1:240 |
*Methodology abbreviations:
Immunofluorescence assay (IFA)
Cell-binding assay (CBA)
Western blot (WB)
Immunoblot (IB)
Neuron-restricted patterns of IgG staining that do not fulfill criteria for ANNA-1, ANNA-2, CRMP-5-IgG, PCA-1, or PCA-2 may be reported as "unclassified anti-neuronal IgG." Complex patterns that include nonneuronal elements may be reported as "uninterpretable."
Day(s) Performed
Profile tests: Monday through Sunday; Reflex tests: Varies
Report Available
8 to 12 daysPerforming Laboratory

Test Classification
This test was developed, and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the US Food and Drug Administration.CPT Code Information
86255 x 11
84182
84182 AGNBS (if appropriate)
86256 AGNTS (if appropriate)
86255 AINCS (if appropriate)
84182 AMIBS (if appropriate)
84182 AN1BS (if appropriate)
86256 AN1TS (if appropriate)
84182 AN2BS (if appropriate)
86256 AN3TS (if appropriate)
86255 APBCS (if appropriate)
86256 APBTS (if appropriate)
86256 APHTS (if appropriate)
86256 CRMTS (if appropriate)
86255 GFACS (if appropriate)
86256 GFATS (if appropriate)
86255 NFHCS (if appropriate)
86255 NFLCS (if appropriate)
86256 NIFTS (if appropriate)
84182 PC1BS (if appropriate)
86256 PC1TS (if appropriate)
86256 PC2TS (if appropriate)
LOINC Code Information
Test ID | Test Order Name | Order LOINC Value |
---|---|---|
AIAES | Axonal, Autoimm/Paraneo, S | 94695-4 |
Result ID | Test Result Name | Result LOINC Value |
---|---|---|
89080 | AGNA-1, S | 84927-3 |
81722 | Amphiphysin Ab, S | 72327-0 |
80150 | ANNA-1, S | 33615-6 |
83137 | ANNA-3, S | 43102-3 |
83107 | CRMP-5-IgG Western Blot, S | 47401-5 |
83138 | PCA-2, S | 84925-7 |
9477 | PCA-1, S | 84924-0 |
64279 | LGI1-IgG CBA, S | 94287-0 |
64281 | CASPR2-IgG CBA, S | 94285-4 |
605155 | GFAP IFA, S | 94346-4 |
606975 | Autoimmune Axonal Interp, S | 69048-7 |
606964 | NIF IFA, S | 96486-6 |
615863 | AP3B2 IFA, S | 101907-4 |
618900 | IFA Notes | 48767-8 |
Special Instructions
Forms
If not ordering electronically, complete, print, and send a Neurology Specialty Testing Client Test Request (T732) with the specimen.