Test ID: PAVAL    
Paraneoplastic, Autoantibody Evaluation, Serum

Serological 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 in the course of, or after, cancer therapy, and are not explainable by metastasis

Differentiating autoimmune neuropathies from neurotoxic effects of chemotherapy

Monitoring the immune response of seropositive patients in the course of cancer therapy

Detecting early evidence of cancer recurrence in previously seropositive patients

If immunofluorescence assay (IFA) (ANN1S, ANN2S, PCABP, PCAB2) patterns are indeterminate, then paraneoplastic autoantibody Western blot is performed at an additional charge.

If IFA patterns suggest amphiphysin antibody, then amphiphysin Western blot is performed at an additional charge.

If IFA patterns suggest GAD65 antibody, then GAD65 antibody radioimmunoassay is performed at an additional charge.

If IFA pattern suggest NMDA-R, then NMDA-R antibody cell-binding assay (CBA), and/or NMDA-R antibody titer is performed at an additional charge.

If IFA pattern suggest AMPA-R, then AMPA-R antibody CBA and/or AMPA-R antibody titer is performed at an additional charge.

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

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

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

If VGKC is >0.00 nmol/L, then LGI1-IgG CBA and CASPR2-IgG CBA, S are performed at an additional charge.

If CRMP IFA is positive, then ACh receptor binding antibody, CRMP-5-IgG Western blot, and ACh receptor (muscle) modulating antibody will be performed at an additional charge.

If striational striated muscle antibody is 1:7,680 or greater, then ACh receptor binding antibody, CRMP-5-IgG Western blot, and ACh receptor (muscle) modulating antibody will be performed at an additional charge.

CRMP-5-IgG Western blot is also performed by specific request for more sensitive detection of CRMP-5-IgG. Testing should be requested in cases of subacute basal ganglionic disorders (chorea, Parkinsonism), cranial neuropathies (especially loss of vision, taste, or smell) and myelopathies.

The following algorithms are available in Special Instructions

-Paraneoplastic Evaluation Algorithm

-Hereditary Peripheral Neuropathy Diagnostic Algorithm

• Paraneoplastic Evaluation Algorithm
• Hereditary Peripheral Neuropathy Diagnostic Algorithm

ANN1S, ANN2S, ANN3S, PCABP, PCAB2, PCATR, AMPHS, CRMS, AGN1S, AMPIS, NMDIS, GABIS, DPPIS, DPPTS, GL1IS, GL1TS: Indirect Immunofluorescence Assay (IFA)

STR: Enzyme-Linked Immunosorbent Assay (ELISA)

CCPQ, CCN, ARBI, GANG, VGKC, GD65S: Radioimmunoassay (RIA)

WBN, ABLOT, CRMWS: Western Blot

NMDCS, AMPCS, GABCS, LG1CS, CS2CS, DPPCS, GL1CS: Cell-Binding Assay (CBA)

ARMO: Live Cell Assay (LCA)