TEST CATALOG ORDERING & RESULTS SPECIMEN HANDLING CUSTOMER SERVICE EDUCATION & INSIGHTS
Test Catalog

Test ID: PCDES    
Pediatric Autoimmune Central Nervous System Disorders Evaluation, Serum

Useful For Suggests clinical disorders or settings where the test may be helpful

Evaluating children with autoimmune central nervous system disorders using serum specimens

Testing Algorithm Delineates situations when tests are added to the initial order. This includes reflex and additional tests.

If indirect immunofluorescence assay (IFA) patterns suggest ANNA-1 antibody, then ANNA-1 Immunoblot and ANNA-2 Immunoblot are performed at an additional charge.

 

If IFA patterns suggest ANNA-2 antibody, then ANNA-2 immunoblot, ANNA-1 immunoblot, and ANNA-2 antibody IFA are performed at an additional charged.

 

If IFA patterns suggest ANNA-3 antibody, then ANNA-3 IFA is performed at an additional charge.

 

If IFA patterns suggest PCA-1 antibody, then PCA-1 immunoblot and PCA-1 IFA are performed at an additional charge.

 

If IFA patterns suggest PCA-2 antibody, then PCA-2 IFA is performed at an additional charge.

 

If IFA patterns suggest PCA-Tr antibody, then PCA-Tr immunoblot is performed at an additional charge.

 

If IFA patterns suggest AMPHI antibody, then AMPHI antibody IFA is performed at an additional charge.

 

If IFA patterns suggest amphiphysin antibody, then amphiphysin immunoblot and amphiphysin antibody IFA titer are performed at an additional charge.

 

If IFA pattern suggests NMDA-R antibody, then NMDA-R IFA titer is performed at an additional charge.

 

If IFA pattern suggests AMPA-R antibody, then AMPA-R antibody cell-binding assay (CBA) and AMPA-R IFA titer are performed at an additional charge.

 

If IFA pattern suggest GABA-B-R antibody, then GABA-B-R IFA titer is performed at an additional charge.

 

If IFA pattern suggest DPPX antibody, then DPPX antibody CBA and DPPX IFA titer are performed at an additional charge.

 

If IFA pattern suggest mGluR1 antibody, then mGluR1antibody CBA and mGluR1 IFA titer are performed at an additional charge.

 

If IFA pattern suggest GFAP antibody, then GFAP antibody CBA and GFAP IFA titer are performed at an additional charge.

 

If NMO/AQP4-IgG fluorescence-activated cell sorting (FACS) screen assay requires further investigation, then NMO/AQP4-IgG FACS titration assay is performed at an additional charge.

 

If MOG FACS screen assay requires further investigation, then MOG FACS titration assay is performed at an additional charge.

 

See Pediatric Autoimmune Central Nervous System Disorders Evaluation Algorithm-Serum in Special Instructions.

Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test

Autoimmune encephalitis and myelitis is increasingly recognized as a cause of central nervous system (CNS) disease in children and teens. N-methyl-D-aspartate receptor antibody (NMDA-R) encephalitis and myelin oligodendrocyte glycoprotein (MOG) autoimmunity are most common, though other entities, including aquaporin-4 autoimmunity, contactin-associated protein-like 2 (CASPR2) autoimmunity, autoimmune glial fibrillary acidic protein (GFAP) astrocytopathy, and paraneoplastic encephalomyelopathies, may also occur in children.

Reference Values Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.

Test ID

Reporting Name

Methodology

Reference Value

PCSI

Peds Autoimmune CNS Interp, S

Interpretation

NA

GANG

AChR Ganglionic Neuronal Ab, S

Radioimmunoassay (RIA)

< or =0.02 nmol/L

ANN1S

ANNA-1, S

Indirect Immunofluorescence (IFA)

<1:240*

CS2CS

CASPR2-IgG CBA, S

Cell-Binding Assay (CBA)

Negative

DPPIS

DPPX Ab IFA, S

IFA

Negative

GABCS

GABA-B-R Ab CBA, S

CBA

Negative

GD65S

GAD65 Ab Assay, S

RIA

< or =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

MOGFS

MOG FACS, S

Flow Cytometry (FACS)

Negative

NMDCS

NMDA-R Ab CBA, S

CBA

Negative

NMOFS

NMO/AQP4 FACS, S

FACS

Negative

CCN

N-Type Calcium Channel Ab

RIA

< or = 0.03 nmol/L

CCPQ

P/Q-Type Calcium Channel Ab

RIA

< or =0.02 nmol/L

PCATR

PCA-Tr, S

IFA

<1:240*

 

Reflex Information:

Test ID

Reporting Name

Methodology

Reference Value

AGN1S

Anti-Glial Nuclear Ab, Type 1

IFA

<1:240

AGNBS

AGNA-1 Immunoblot, S

Immunoblot (IB)

Negative

AMIBS

Amphiphysin Immunoblot, s

IB

Negative

AMPCS

AMPA-R Ab CBA, S

CBA

Negative

AMPHS

Amphiphysin Ab, S

IFA

<1:240

AMPIS

AMPA-R Ab IF Titer Assay, S

IFA

<1:120

AN1BS

ANNA-1 Immunoblot, S

IB

Negative

AN2BS

ANNA-2 Immunoblot, S

IB

Negative

ANN2S

ANNA-2, S

IFA

<1:240*

ANN3S

ANNA-3, S

IFA

<1:240

DPPCS

DPPX Ab CBA, S

CBA

Negative

DPPTS

DPPX Ab IFA Titer, 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

NMDIS

NMDA-R Ab IF Titer Assay, S

IFA

<1:120

NMOTS

NMO/AQP4 FACS Titer, S

FACS

<1:5

PC1BS

PCA-1 Immunoblot, S

IB

Negative

PCAB2

PCA-2, S

IFA

<1:240*

PCABP

PCA-1, S

IFA

<1:240*

PCTBS

PCA-Tr Immunoblot, S

IB

Negative

 

*Neuron-restricted patterns of IgG staining that do not fulfill criteria for ANNA-1, ANNA-2, PCA-1, PCA-2, or PCA-Tr may be reported as "unclassified anti-neuronal IgG." Complex patterns that include nonneuronal elements may be reported as "uninterpretable."

Interpretation Provides information to assist in interpretation of the test results

This profile is consistent with an autoimmune central nervous system disorder.

Cautions Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances

Negative results do not exclude a diagnosis of an autoimmune central nervous system disorder.

Clinical Reference Recommendations for in-depth reading of a clinical nature

1. Dubey D, Pittock SJ, Krecke KN, et al: Clinical, Radiologic, and Prognostic Features of Myelitis Associated With Myelin Oligodendrocyte Glycoprotein Autoantibody. JAMA Neurol 2019 Mar 1;76(3):301-309 doi: 10.1001/jamaneurol.2018.4053

2. McKeon A, Lennon VA, Lotze T, et al: CNS aquaporin-4 autoimmunity in children. Neurology 2008 Jul 8;71(2):93-100

3. Dubey D, Hinson SR, Jolliffe EA, et al: Autoimmune GFAP astrocytopathy: Prospective evaluation of 90 patients in 1?year. J Neuroimmunol 2018 Aug 15;321:157-163

4. Philipps G, Alisanski SB, Pranzatelli M, et al: Purkinje cell cytoplasmic antibody type 1 (anti-Yo) autoimmunity in a child with Down syndrome. JAMA Neurol 2014 Mar;71(3):347-349

5. Lopez-Chiriboga AS, Klein C, Zekeridou A, et al: LGI1 and CASPR2 neurological autoimmunity in children. Ann Neurol 2018 Sep;84(3):473-480

6. Lopez-Chiriboga AS, Majed M, Fryer J, et al: Association of MOG-IgG Serostatus With Relapse After Acute Disseminated Encephalomyelitis and Proposed Diagnostic Criteria for MOG-IgG-Associated Disorders. JAMA Neurol 2018 Nov 1;75(11):1355-1363

7. Clardy SL, Lennon VA, Dalmau J: Childhood onset of stiff-man syndrome. JAMA Neurol 2013 Dec;70(12):1531-1536

8. Banwell B, Tenembaum S, Lennon VA, et al: Neuromyelitis optica-IgG in childhood inflammatory demyelinating CNS disorders. Neurology 2008 Jan 29;70(5):344-352

Special Instructions Library of PDFs including pertinent information and forms related to the test