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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, S

Specimen Type

Serum

Specimen 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 days

Performing Laboratory

Mayo Clinic Laboratories in Rochester

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 94340-7
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 84926-5
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 In Process
618900 IFA Notes 48767-8