Test Id : AIAES
Axonal Neuropathy, Autoimmune/Paraneoplastic Evaluation, Serum
Useful For
Suggests clinical disorders or settings where the test may be helpful
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
A profile is a group of laboratory tests that are ordered and performed together under a single Mayo Test ID. Profile information lists the test performed, inclusive of the test fee, when a profile is ordered and includes reporting names and individual availability.
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 |
IG5CS | IgLON5 CBA, 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
Lists tests that may or may not be performed, at an additional charge, depending on the result and interpretation of the initial 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 |
IG5TS | IgLON5 IFA Titer, S | No | No |
Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.
If the indirect immunofluorescence assay (IFA) patterns suggest antiglial nuclear antibody-1 (AGNA-1), then the 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 the ANNA-1 IFA titer, ANNA-1 immunoblot, and ANNA-2 immunoblot will be performed at an additional charge.
If the client requests or the IFA pattern suggests ANNA-3 antibody, then the ANNA-3 IFA titer will be performed at an additional charge.
If the IFA pattern suggests Purkinje cytoplasmic antibody type 1 (PCA-1), then the 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 the PCA-2 antibody IFA titer will be performed at an additional charge.
If the IFA patterns suggest amphiphysin antibody, then the 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 the 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 result is positive, then the 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 the 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 the alpha internexin CBA, NIF heavy chain CBA, NIF light chain CBA, and NIF IFA titer will be performed at an additional charge.
If the IgLON family member 5 antibody (IgLON5) by CBA result is positive, then the IgLON5 antibody IFA titer will be performed at an additional charge.
For more information see:
-Autoimmune/Paraneoplastic Axonal Neuropathy Evaluation Algorithm.
Method Name
A short description of the method used to perform the test
AIAEI - Medical Interpretation
APBCS, CS2CS, LG1CS, AINCS, NFLCS, NFHCS, GFACS, IG5CS: Cell Binding Assay (CBA)
AGN1S, AGNTS, AMPHS, APHTS, ANN1S, AN1TS, ANN3S, AN3TS, APBIS, APBTS, NIFIS, NIFTS, PCABP, PCAB2, PC1TS, PC2TS, GFAIS, GFATS, CRMTS, IG5TS: Indirect Immunofluorescence Assay (IFA)
CRMWS; Western Blot (WB)
AGNBS, AMIBS, AN1BS, PC1BS, AN2BS: Immunoblot (IB)
NY State Available
Indicates the status of NY State approval and if the test is orderable for NY State clients.
Reporting Name
Lists a shorter or abbreviated version of the Published Name for a test
Aliases
Lists additional common names for a test, as an aid in searching
Autoimmune Neuropathy
Peripheral Neuropathy
Neuropathy
Axonal Neuropathy
Polyradiculopathy
Autonomic Neuropathy
Motor Neuropathy
Sensory Neuropathy
Small Fiber Neuropathy
Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.
If the indirect immunofluorescence assay (IFA) patterns suggest antiglial nuclear antibody-1 (AGNA-1), then the 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 the ANNA-1 IFA titer, ANNA-1 immunoblot, and ANNA-2 immunoblot will be performed at an additional charge.
If the client requests or the IFA pattern suggests ANNA-3 antibody, then the ANNA-3 IFA titer will be performed at an additional charge.
If the IFA pattern suggests Purkinje cytoplasmic antibody type 1 (PCA-1), then the 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 the PCA-2 antibody IFA titer will be performed at an additional charge.
If the IFA patterns suggest amphiphysin antibody, then the 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 the 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 result is positive, then the 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 the 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 the alpha internexin CBA, NIF heavy chain CBA, NIF light chain CBA, and NIF IFA titer will be performed at an additional charge.
If the IgLON family member 5 antibody (IgLON5) by CBA result is positive, then the IgLON5 antibody IFA titer will be performed at an additional charge.
For more information see:
-Autoimmune/Paraneoplastic Axonal Neuropathy Evaluation Algorithm.
Specimen Type
Describes the specimen type validated for testing
Serum
Ordering Guidance
Multiple neurological phenotype-specific autoimmune/paraneoplastic evaluations are available. For more information as well as phenotype-specific testing options, see Autoimmune Neurology Test Ordering Guide.
When more than one evaluation is ordered on the same order number, the duplicate test will be canceled.
For a list of antibodies performed with each evaluation, see Autoimmune Neurology Antibody Matrix.
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.
Necessary Information
Provide the following information:
-Relevant clinical information
-Ordering healthcare professional's name, phone number, mailing address, and email address
Specimen Required
Defines the optimal specimen required to perform the test and the preferred volume to complete testing
Patient Preparation:
For optimal antibody detection, specimen collection is recommended prior to initiation of immunosuppressant medication or intravenous immunoglobulin (IVIg) treatment.
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.
Special Instructions
Library of PDFs including pertinent information and forms related to the test
Forms
If not ordering electronically, complete, print, and send a Neurology Specialty Testing Client Test Request (T732) with the specimen.
Specimen Minimum Volume
Defines the amount of sample necessary to provide a clinically relevant result as determined by the testing laboratory. The minimum volume is sufficient for one attempt at testing.
2 mL
Reject Due To
Identifies specimen types and conditions that may cause the specimen to be rejected
Gross hemolysis | Reject |
Gross lipemia | Reject |
Gross icterus | Reject |
Specimen Stability Information
Provides a description of the temperatures required to transport a specimen to the performing laboratory, alternate acceptable temperatures are also included
Specimen Type | Temperature | Time | Special Container |
---|---|---|---|
Serum | Refrigerated (preferred) | 28 days | |
Ambient | 72 hours | ||
Frozen | 28 days |
Useful For
Suggests clinical disorders or settings where the test may be helpful
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
Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.
If the indirect immunofluorescence assay (IFA) patterns suggest antiglial nuclear antibody-1 (AGNA-1), then the 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 the ANNA-1 IFA titer, ANNA-1 immunoblot, and ANNA-2 immunoblot will be performed at an additional charge.
If the client requests or the IFA pattern suggests ANNA-3 antibody, then the ANNA-3 IFA titer will be performed at an additional charge.
If the IFA pattern suggests Purkinje cytoplasmic antibody type 1 (PCA-1), then the 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 the PCA-2 antibody IFA titer will be performed at an additional charge.
If the IFA patterns suggest amphiphysin antibody, then the 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 the 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 result is positive, then the 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 the 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 the alpha internexin CBA, NIF heavy chain CBA, NIF light chain CBA, and NIF IFA titer will be performed at an additional charge.
If the IgLON family member 5 antibody (IgLON5) by CBA result is positive, then the IgLON5 antibody IFA titer will be performed at an additional charge.
For more information see:
-Autoimmune/Paraneoplastic Axonal Neuropathy Evaluation Algorithm.
Clinical Information
Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test
Neuropathy patients have variable sensory disturbance (loss or exaggerated sensation) with pain, weakness, and autonomic involvements such as sweat abnormalities, gastrointestinal dysfunction, and lightheadedness on standing. These symptoms result from injury to the distal nerves, roots, ganglia, or their gathering points (nerve plexus in the thighs and arms). Patients may have symmetric or asymmetric involvements of the extremities, trunk, and head, including extraocular muscles. Subacute onsets and asymmetric involvements favor inflammatory or immune causes over inherited or metabolic forms. Depending on the specific inflammatory or immune mediated causes other parts of the nervous system may also be affected (brain, cerebellum, spinal cord).
In the evaluation of patients with immune-mediated autoantibody neuropathies, nerve conduction studies and needle electromyography can help to classify the neuropathy as either primary axonal, primary demyelinating, or mixed axonal and demyelinating. This evaluation focuses on persons with primary axonal forms.
Well established neuronal autoantibodies responsible for axonal neuropathies include antineuronal nuclear antibody (ANNA1 and 3), Purkinje cytoplasmic antibody (PCA1 and 2), amphiphysin antibody, collapsin response mediator protein 5 (CRMP5) antibody, leucine-rich glioma inactivated 1 protein (LGI1) antibody, and contactin-associated response protein 2 (CASPR2) antibody. Other autoantibodies have preliminary evidence to support their association with neuropathy, including antiglial nuclear antibody (AGNA), antineuronal nuclear antibody type 2 (ANNA2), and glial fibrillary acidic protein (GFAP) antibody.
A patient's humoral and cellular immune response leads to the neurological syndrome. This may be related to an underlying cancer or unidentified antigen trigger. If related to cancer, it may be a new or recurrent malignancy, is usually limited in metastatic volume, and is often occult by standard imaging procedures. Autoantibodies specific for onconeural proteins found in the plasma membrane, cytoplasm, and nucleus of neurons, glia, or muscle are generated in this immune response and serve as serological markers of paraneoplastic autoimmunity. Cancers recognized in this context most commonly are small-cell lung carcinoma, thymoma, ovarian (or related Mullerian) carcinoma, breast carcinoma, and Hodgkin lymphoma. Pertinent childhood neoplasms recognized thus far include neuroblastoma, thymoma, Hodgkin lymphoma, and chondroblastoma.
This evaluation focuses on those antibodies with known associations with varied forms of peripheral axonal neuropathy. Seropositive patients usually present with subacute neurological symptoms of radiculopathy; plexopathy; or sensory, sensorimotor, or autonomic neuropathy, with or without a neuromuscular transmission disorder, such as neuromuscular hyperexcitability. Other peripheral manifestations include cranial neuropathies, especially loss of vision, hearing, smell, or taste. Commonly beyond the peripheral manifestation are encephalopathy, seizures, cerebellar ataxia, and myelopathy. Initial signs may be subtle, but a subacute multifocal and progressive syndrome usually evolves. Sensorimotor neuropathy and cerebellar ataxia are common presentations, but the clinical picture in some patients is dominated by striking gastrointestinal dysmotility and limbic encephalopathy. Some patients may present with mostly pain and have a limited small fiber neuropathy with or without autonomic symptoms.
Cancer risk factors include previous or family history of cancer, history of smoking, or social or environmental exposure to carcinogens.
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 |
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 |
IG5CS | IgLON5 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 |
IG5TS | IgLON5 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."
Interpretation
Provides information to assist in interpretation of the test results
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 individuals and are usually accompanied by subacute neurological signs and symptoms. Several autoantibodies have a syndromic association, but no autoantibody predicts a specific neurological syndrome. More than one paraneoplastic autoantibody may be detected and associated with specific cancers.
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 the possibility of a cancer diagnosis.
Intravenous immunoglobulin (IVIg) treatment prior to the serum collection may cause a false-positive result.
Clinical Reference
Recommendations for in-depth reading of a clinical nature
1. Klein CJ. Autoimmune-mediated peripheral neuropathies and autoimmune pain. In: Pittock SJ, Vincent A, eds. Autoimmune Neurology. Elsevier; 2016:417-446. Aminoff MJ, Boller F, Swaab DF, eds. Handbook of Clinical Neurology; vol 133
2. Cutsforth-Gregory JK, McKeon A, Coon EA, et al. Ganglionic antibody level as a predictor of severity of autonomic failure. Mayo Clin Proc. 2018;93(10):1440-1447
3. Wei YC, Huang CC, Liu CH, Kuo HC, Lin JJ. Peripheral neuropathy in limbic encephalitis with anti-glutamate receptor antibodies: Case report and systematic literature review. Brain Behav. 2017;7(9):e00779
4. Lucchinetti CF, Kimmel DW, Lennon VA. Paraneoplastic and oncologic profiles of patients seropositive for type 1 antineuronal nuclear autoantibodies. Neurology. 1998;50(3):652-657. doi:10.1212/wnl.50.3.652
5. Pittock SJ, Lucchinetti CF, Lennon VA. Anti-neuronal nuclear autoantibody type 2: paraneoplastic accompaniments. Ann Neurol. 2003;53(5):580-587
6. Chan KH, Vernino S, Lennon VA. ANNA-3 anti-neuronal nuclear antibody: marker of lung cancer-related autoimmunity. Ann Neurol. 2001;50(3):301-311
7. Dubey D, Lennon VA, Gadoth A, et al. Autoimmune CRMP5 neuropathy phenotype and outcome defined from 105 cases. Neurology. 2018;90(2):e103-e110
8. Gadoth A, Pittock SJ, Dubey D, et al. Expanded phenotypes and outcomes among 256 LGI1/CASPR2-IgG-positive patients. Ann Neurol. 2017;82(1):79-92
9. Honnorat J, Trouillas P, Thivolet C, Aguera M, Belin MF. Autoantibodies to glutamate decarboxylase in a patient with cerebellar cortical atrophy, peripheral neuropathy, and slow eye movements. Arch Neurol. 1995;52(5):462-468
10. McKeon A, Tracy JA. GAD65 neurological autoimmunity. Muscle Nerve. 2017;56(1):15-27
11. Bradshaw MJ, Haluska P, McKeon A, Klein CJ. Multifocal neuropathy as the presenting symptom of Purkinje cell cytoplasmic autoantibody-1. Muscle Nerve. 2013;48:827-831
12. Pittock SJ, Lucchinetti CF, Parisi JE, et al. Amphiphysin autoimmunity: paraneoplastic accompaniments. Ann Neurol. 2005;58(1):96-107
Method Description
Describes how the test is performed and provides a method-specific reference
Cell-Binding Assay:
Patient sample is applied to a composite slide containing transfected and nontransfected EU90 cells. After incubation and washing, fluorescein-conjugated goat-antihuman IgG is applied to detect the presence of patient IgG binding.(Package insert: IIFT: Neurology Mosaics, Instructions for the indirect immunofluorescence test. EUROIMMUN; FA_112d-1_A_UK_C13, 02/25/2019)
Indirect Immunofluorescence Assay:
The patient's sample is tested by a standardized immunofluorescence assay that uses a composite frozen section of mouse cerebellum, kidney, and gut tissues. After incubation with sample and washing, fluorescein-conjugated goat-antihuman IgG is applied. Neuron-specific autoantibodies are identified by their characteristic fluorescence staining patterns. Samples that are scored positive for any neuronal nuclear or cytoplasmic autoantibody are titrated to an endpoint. Interference by coexisting non-neuron-specific autoantibodies can usually be eliminated by serologic absorption.(Honorat JA, Komorowski L, Josephs KA, et al. IgLON5 antibody: neurological accompaniments and outcomes in 20 patients. Neurol Neuroimmunol Neuroinflamm. 2017;4[5]:e385. doi:10.1212/NXI.0000000000000385)
Western Blot:
Full-length recombinant human collapsin response mediator protein 5 (CRMP-5) antigen is used to detect CRMP-5-IgG using traditional western blot.(Yu Z, Kryzer TJ, Griesmann GE, et al. CRMP-5 neuronal autoantibody: marker of lung cancer and thymoma-related autoimmunity. Ann Neurol. 2001;49[2]:145-154; Dubey D, Jitprapaikulsan J, Bi H, et al. Amphiphysin-IgG autoimmune neuropathy: A recognizable clinicopathologic syndrome. Neurology. 2019;93[20]:e1873-e1880. doi:10.1212/WNL.0000000000008472)
Immunoblot:
All steps are performed at ambient temperature (18-28 degrees C) utilizing the EUROBlot One instrument. Diluted patient sample is added to test strips (strips containing recombinant antigen manufactured and purified using biochemical methods) in individual channels and incubated for 30 minutes. Positive samples will bind to the purified recombinant antigen and negative samples will not bind. Strips are washed to remove unbound antibodies and then are incubated with antihuman IgG antibodies (alkaline phosphatase-labelled) for 30 minutes. The strips are again washed to remove unbound antihuman IgG antibodies and nitroblue tetrazolium chloride/5-bromo-4-chloro-3-indolylphosphate substrate is added. Alkaline phosphatase enzyme converts the soluble substrate into a colored insoluble product on the membrane to produces a black band. Strips are digitized via picture capture on the EUROBlot One instrument and evaluated with the EUROLineScan software.(O'Connor K, Waters P, Komorowski L, et al. GABAA receptor autoimmunity: A multicenter experience. Neurol Neuroimmunol Neuroinflamm. 2019;6[3]:e552. doi:10.1212/NXI.0000000000000552)
PDF Report
Indicates whether the report includes an additional document with charts, images or other enriched information
Day(s) Performed
Outlines the days the test is performed. This field reflects the day that the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time before the test is performed. Some tests are listed as continuously performed, which means that assays are performed multiple times during the day.
Profile tests: Monday through Sunday; Reflex tests: Varies
Report Available
The interval of time (receipt of sample at Mayo Clinic Laboratories to results available) taking into account standard setup days and weekends. The first day is the time that it typically takes for a result to be available. The last day is the time it might take, accounting for any necessary repeated testing.
Specimen Retention Time
Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded
Performing Laboratory Location
Indicates the location of the laboratory that performs the test
Fees :
Several factors determine the fee charged to perform a test. Contact your U.S. or International Regional Manager for information about establishing a fee schedule or to learn more about resources to optimize test selection.
- Authorized users can sign in to Test Prices for detailed fee information.
- Clients without access to Test Prices can contact Customer Service 24 hours a day, seven days a week.
- Prospective clients should contact their account representative. For assistance, contact Customer Service.
Test Classification
Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR) product.
This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.
CPT Code Information
Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Clinic Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.
CPT codes are provided by the performing laboratory.
CPT codes are provided by the performing laboratory.
86255 x 12
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)
86256 IG5TS (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® Information
Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the order and results codes of this test. LOINC values are provided by the performing laboratory.
Test Id | Test Order Name | Order LOINC Value |
---|---|---|
AIAES | Axonal, Autoimm/Paraneo, S | 94695-4 |
Result Id | Test Result Name |
Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
|
---|---|---|
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 |
618900 | IFA Notes | 48767-8 |
606964 | NIF IFA, S | 96486-6 |
606950 | IgLON5 CBA, S | 96478-3 |
615863 | AP3B2 IFA, S | 101907-4 |
Test Setup Resources
Setup Files
Test setup information contains test file definition details to support order and result interfacing between Mayo Clinic Laboratories and your Laboratory Information System.
Sample Reports
Normal and Abnormal sample reports are provided as references for report appearance.
SI Sample Reports
International System (SI) of Unit reports are provided for a limited number of tests. These reports are intended for international account use and are only available through MayoLINK accounts that have been defined to receive them.
Test Update Resources
Change Type | Effective Date |
---|---|
File Definition - Algorithm | 2024-06-04 |