Paraneoplastic Autoantibody Evaluation, Serum


Sunquest Code:PNPLTP  
Epic Code:LAB3686Epic Name:Paraneoplastic Antibody
Synonyms:Neuronal Antibody; Calcium Channel Binding Antibody
Methodology:Indirect immunofluorescence, enzyme immunoassay, radioimmunoassay, Western blot; cell-binding assay; NMO-IgG fluorescence-activated cell sorting assay
CPT Code:83520, 86256, 83519 x5, 86255 x9
Test Includes:Antineuronal nuclear aby, Type 1,2 and 3; ; Purkinje cell cytoplasmic aby Type 1,2 and Tr; Amphiphysin Aby, S; CRMP-5-IgG; Striational (Striated Muscle) Aby, S; Calcium channel binding aby, P/Q; Ach Receptor (muscle) binding aby. The following tests are reflexed and charged separately as indicated: Paraneoplas Autoantibody Western Blot; CRMP-5-IgG Western Blot; GAD65 Ab Assay S; Arch Receptor (muscle) modulating aby; Amphiphysin Western Blot, S; NMO/AQP4-IgG, CBA, S; NMDA-R Ab CBA, S; R Ab CBA, S; GABA-B-R Ab CBA, S; NMDA-R Ab IF Titer Assay, S; AMPA-R Ab IF Titer Assay, S; GABA-B-R Ab IF Titer Assay, S.
Turnaround Time:Specimens are sent to reference laboratory Mon-Fri; results are reported in 10-17 days.
Special Instructions:Include relevant clinical information, name, phone number, mailing address of ordering physician. 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.
Compliance:

This test was developed and its performance characteristics determined by Laboratory Medicine and Pathology, Mayo Clinic. This test has not been cleared by the U.S. Food and Drug Administration.



Collection Instructions

Specimen:Blood
Optimal Volume:8 mL
Minimum\Peds Volume:4.2 mL
Container:Red or gold (gel) (Red (no gel))
Causes for Rejection:Grossly hemolyzed, lipemic or icteric specimen.


Processing and Shipping

Specimen Processing:Centrifuge and aliquot 4 mL, 2 mL minimum. Store in refrigerator.
Shipping Instructions:Ship at refrigerated temperature.
Test Performed at or Referral Lab Lab Sendouts  (Mayo)
Referral Lab number:PAVAL


Interpretive

Reference Range:

 

Neuronal Nuclear Antibodies

Antineuronal Nuclear Antibody -Type 1 (ANNA-1)

Negative at less than 1:240

Antineuronal Nuclear Antibody -Type 2 (ANNA-2)

Negative at less than 1:240

Antineuronal Nuclear Antibody -Type 3 (ANNA-3)

Negative at less than 1:240

Anti-Glial/Neuronal Nuclear Antibody – Type 1 (AGNA-1)

Negative at less than 1:240

 

Neuronal and Muscle Cytoplasmic Antibodies

Purkinje Cell Cytoplasmic Antibody, Type 1 (PCA-1)

Negative at less than 1:240

Purkinje Cell Cytoplasmic Antibody, Type 2 (PCA-2)

Negative at less than 1:240

Purkinje Cell Cytoplasmic Antibody, Type Tr (PCA-Tr)

Negative at less than 1:240

Amphiphysin Antibody

Negative at less than 1:240

CRMP-5-IgG

Negative at less than 1:240

 

Cation Channel Antibodies

Calcium Channel

Antibody, N-Type

0.03 nmol/L or less

Calcium Channel

Antibody, P/Q-Type

0.02 nmol/L or less

ACh Receptor (Muscle) Binding Antibody

0.02 nmol/L or less

AChR Ganglionic Neural Antibody

0.02 nmol/L or less

Voltage-Gated Potassium Channel Antibody

0.02 nmol/L or less

 

Neuronal-restricted patterns of IgG staining that do not fulfill criteria for amphiphysin, ANNA-1, ANNA-2, PCA-1, PCA-2, PCA-Tr or CRMP-5-IgG may be reported as “unclassified antineuronal IgG”. Complex patterns that include non-neuronal elements may be reported as “uninterpretable”.

 

Use: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 or chemotherapy. Monitoring the immune response of seropositive patients in the course of cancer therapy. Detecting early evidence of cancer recurrence in previously seropositive patients.


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