Test ID PCDES Pediatric Autoimmune Encephalopathy/CNS Disorder 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 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
Evaluating children with autoimmune central nervous system disorders using serum specimens
Profile Information
Test ID | Reporting Name | Available Separately | Always Performed |
---|---|---|---|
PCSI | Peds Autoimmune CNS Interp, S | No | Yes |
ANN1S | Anti-Neuronal Nuclear Ab, Type 1 | No | Yes |
CS2CS | CASPR2-IgG CBA, S | No | Yes |
DPPIS | DPPX Ab IFA, S | No | Yes |
GABCS | GABA-B-R Ab CBA, S | No | Yes |
GD65S | GAD65 Ab Assay, S | Yes | Yes |
GFAIS | GFAP IFA, S | No | Yes |
LG1CS | LGI1-IgG CBA, S | No | Yes |
GL1IS | mGluR1 Ab IFA, S | No | Yes |
MOGFS | MOG FACS, S | Yes | Yes |
NCDIS | Neurochondrin IFA, S | No | Yes |
NMDCS | NMDA-R Ab CBA, S | No | Yes |
NMOFS | NMO/AQP4 FACS, S | Yes | Yes |
PCATR | Purkinje Cell Cytoplasmic Ab Type Tr | No | Yes |
Reflex Tests
Test ID | Reporting Name | Available Separately | Always Performed |
---|---|---|---|
AN1BS | ANNA-1 Immunoblot, S | No | No |
AN2BS | ANNA-2 Immunoblot, S | No | No |
DPPCS | DPPX Ab CBA, S | No | No |
DPPTS | DPPX Ab IFA Titer, S | No | No |
GFACS | GFAP CBA, S | No | No |
GFATS | GFAP IFA Titer, S | No | No |
GL1CS | mGluR1 Ab CBA, S | No | No |
GL1TS | mGluR1 Ab IFA Titer, S | No | No |
MOGTS | MOG FACS Titer, S | No | No |
NMDIS | NMDA-R Ab IF Titer Assay, S | No | No |
NMOTS | NMO/AQP4 FACS Titer, S | No | No |
PCTBS | PCA-Tr Immunoblot, S | No | No |
AN1TS | ANNA-1 Titer, S | No | No |
GABIS | GABA-B-R Ab IF Titer Assay, S | No | No |
NCDCS | Neurochondrin CBA, S | No | No |
NCDTS | Neurochondrin IFA Titer, S | No | No |
PCTTS | PCA-Tr Titer, S | No | No |
Testing Algorithm
If the indirect immunofluorescence assay (IFA) pattern suggests antineuronal nuclear antibody type 1 (ANNA-1), then ANNA-1 immunoblot, ANNA-1 IFA titer and ANNA-2 immunoblot will be performed at an additional charge.
If the IFA pattern suggests Purkinje cytoplasmic antibody (PCA)-Tr , then PCA-Tr immunoblot and PCA-Tr IFA titer will be performed at an additional charge.
If N-methyl-D-aspartate receptor (NMDA-R) antibody cell binding assay (CBA) is positive, then NMDA-R IFA titer will be performed at an additional charge.
If gamma-aminobutyric acid B receptor (GABA-B-R) antibody CBA is positive, then GABA-B-R IFA titer will be performed at an additional charge.
If the IFA pattern suggests dipeptidyl-peptidase-like protein-6 (DPPX) antibody, then DPPX antibody CBA and DPPX IFA titer will be performed at an additional charge.
If the IFA pattern suggests metabotropic glutamate receptor 1 (mGluR1) antibody, then mGluR1 antibody CBA and mGluR1 IFA titer will be performed at an additional charge.
If the IFA pattern suggests glial fibrillary acidic protein (GFAP) antibody, then GFAP antibody CBA and GFAP IFA titer will be performed at an additional charge.
If the neuromyelitis optica/aquaporin-4-IgG (NMO/AQP4-IgG) fluorescence-activated cell sorting (FACS) screen assay requires further investigation, then NMO/AQP4-IgG FACS titration assay will be performed at an additional charge.
If the myelin oligodendrocyte glycoprotein (MOG) FACS screen assay requires further investigation, then MOG FACS titration assay will be performed at an additional charge.
If IFA pattern suggests neurochondrin antibody, then neurochondrin antibody CBA and neurochondrin IFA titer will be performed at an additional charge.
For more information, see the following:
Pediatric Autoimmune Encephalopathy/Central Nervous System Disorders Evaluation Algorithm-Serum
Pediatric Autoimmune Central Nervous System Demyelinating Disease Diagnostic Algorithm
Method Name
CS2CS, DPPCS, GABCS, GFACS, LG1CS, GL1CS, NCDCS, NMDCS: Cell Binding Assay (CBA)
MOGFS, MOGTS, NMOFS, NMOTS: Flow Cytometry
ANN1S, AN1TS, DPPIS, DPPTS, GABIS, GFAIS, GFATS, GL1IS, GL1TS, NCDIS, NCDTS, NMDIS, PCATR, PCTTS: Indirect Immunofluorescence (IFA)
GD65S: Radioimmunoassay (RIA)
AN1BS, AN2BS, PCTBS: Immunoblot (IB)
Reporting Name
Peds Autoimm Enceph CNS, 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 |
PCSI |
Peds Autoimmune CNS Interp, S |
Medical interpretation |
NA |
ANN1S |
Anti-Neuronal Nuclear Ab, Type 1 |
IFA |
Negative |
CS2CS |
CASPR2-IgG CBA, S |
CBA |
Negative |
DPPIS |
DPPX Ab IFA, S |
IFA |
Negative |
GABCS |
GABA-B-R Ab CBA, S |
CBA |
Negative |
GD65S |
GAD65 Ab Assay, S |
RIA |
≤0.02 nmol/L Reference values apply to all ages. |
GFAIS |
GFAP IFA, S |
IFA |
Negative |
LG1CS |
LGI1-IgG CBA, S |
CBA |
Negative |
GL1IS |
mGluR1 Ab IFA, S |
IFA |
Negative |
NCDIS |
Neurochondrin IFA, S |
IFA |
Negative |
MOGFS |
MOG FACS, S |
FACS |
Negative |
NMDCS |
NMDA-R Ab CBA, S |
CBA |
Negative |
NMOFS |
NMO/AQP4 FACS, S |
FACS |
Negative |
PCATR |
 Purkinje Cell Cytoplasmic Ab Type Tr |
IFA |
Negative |
Reflex Information:
Test ID |
Reporting name |
Methodology |
Reference value |
AN1BS |
ANNA-1 Immunoblot, S |
IB |
Negative |
AN1TS |
ANNA-1 Titer, S |
IFA |
<1:240 |
AN2BS |
ANNA-2 Immunoblot, S |
IB |
Negative |
DPPCS |
DPPX Ab CBA, S |
CBA |
Negative |
DPPTS |
DPPX Ab IFA Titer, S |
IFA |
<1:240 |
GABIS |
GABA-B-R Ab IF Titer Assay, S |
IFA |
<1:240 |
GFACS |
GFAP CBA, S |
CBA |
Negative |
GFATS |
GFAP IFA Titer, S |
IFA |
<1:240 |
GL1CS |
mGluR1 Ab CBA, S |
CBA |
Negative |
GL1TS |
mGluR1 Ab IFA Titer, S |
IFA |
<1:240 |
MOGTS |
MOG FACS Titer, S |
FACS |
<1:20 |
NCDCS |
Neurochondrin CBA, S |
CBA |
Negative |
NCDTS |
Neurochondrin IFA Titer, S |
IFA |
<1:240 |
NMDIS |
NMDA-R Ab IF Titer Assay, S |
IFA |
<1:240 |
NMOTS |
NMO/AQP4 FACS Titer, S |
FACS |
<1:5 |
PCTTS |
PCA-Tr Titer, S |
IFA |
<1:240 |
PCTBS |
PCA-Tr Immunoblot, S |
IB |
Negative |
*Methodology abbreviations:
Immunofluorescence assay (IFA)
Cell-binding assay (CBA)
Fluorescence activated cell sorting assay (FACS)
Radioimmunoassay (RIA)
Immunoblot (IB)
**Neuron-restricted patterns of IgG staining that do not fulfill criteria for ANNA-1, ANNA-2, or PCA-Tr may be reported as "unclassified anti-neuronal IgG." Complex patterns that include non-neuronal 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
86341
86363
86053
86255 x 10
84182 AN1BS (if appropriate)
86256 AN1TS (if appropriate)
84182 AN2BS (if appropriate)
86255 DPPCS (if appropriate)
86256 DPPTS (if appropriate)
86256 GABIS (if appropriate)
86255 GFACS (if appropriate)
86256 GFATS (if appropriate)
86255 GL1CS (if appropriate)
86256 GL1TS (if appropriate)
86363 MOGTS (if appropriate)
86255 NCDCS (if appropriate)
86256 NCDTS (if appropriate)
86256 NMDIS (if appropriate)
86053 NMOTS (if appropriate)
84182 PCTBS (if appropriate)
86256 PCTTS (if appropriate)
LOINC Code Information
Test ID | Test Order Name | Order LOINC Value |
---|---|---|
PCDES | Peds Autoimm Enceph CNS, S | 101417-4 |
Result ID | Test Result Name | Result LOINC Value |
---|---|---|
61516 | NMDA-R Ab CBA, S | 93503-1 |
61519 | GABA-B-R Ab CBA, S | 93428-1 |
38324 | NMO/AQP4 FACS, S | 43638-6 |
64279 | LGI1-IgG CBA, S | 94287-0 |
64281 | CASPR2-IgG CBA, S | 94285-4 |
65563 | MOG FACS, S | 90248-6 |
64930 | DPPX Ab IFA, S | 82976-2 |
64928 | mGluR1 Ab IFA, S | 94347-2 |
605155 | GFAP IFA, S | 94346-4 |
605131 | Peds Autoimmune CNS Interp, S | 69048-7 |
80150 | ANNA-1, S | 33615-6 |
81596 | GAD65 Ab Assay, S | 30347-9 |
83076 | PCA-Tr, S | 94352-2 |
615867 | Neurochondrin IFA, S | 101452-1 |
618907 | 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.