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Test Code AIAES Axonal Neuropathy, Autoimmune/Paraneoplastic Evaluation, 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


Patient Preparation: For optimal antibody detection, collect specimen before starting immunosuppressant medication or intravenous immunoglobulin 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 Serum

Collection Instructions: Centrifuge and aliquot serum into a plastic vial.


Useful For

Evaluation of patients who present with a subacute neurological disorder of undetermined etiology, especially those with known risk factors for cancer using serum specimens

 

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

Test ID Reporting Name Available Separately Always Performed
AIAEI Autoimmune Axonal Interp, S No Yes
AMPHS Amphiphysin Ab, S No Yes
AGN1S Anti-Glial Nuclear Ab, Type 1 No Yes
ANN1S Anti-Neuronal Nuclear Ab, Type 1 No Yes
ANN3S Anti-Neuronal Nuclear Ab, Type 3 No Yes
APBIS AP3B2 IFA, S No Yes
CS2CS CASPR2-IgG CBA, S No Yes
CRMS CRMP-5-IgG, S No Yes
IG5CS IgLON5 CBA, S No Yes
LG1CS LGI1-IgG CBA, S No Yes
PCAB2 Purkinje Cell Cytoplasmic Ab Type 2 No Yes

Reflex Tests

Test ID Reporting Name Available Separately Always Performed
AGNBS AGNA-1 Immunoblot, S No No
AGNTS AGNA-1 Titer, S No No
APHTS Amphiphysin Ab Titer, 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
CRMTS CRMP-5-IgG Titer, S No No
IG5TS IgLON5 IFA Titer, S No No
MP1BS MAP1B Immunoblot, S No No
PC2TS PCA-2 Titer, S No No
CRMWS CRMP-5-IgG Western Blot, S No No

Testing Algorithm

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 IFA pattern suggests ANNA-3 antibody or the client requests it, then the ANNA-3 IFA titer will be performed at an additional charge.

 

If the IFA pattern suggests PCA-2 antibody, then the PCA-2 antibody IFA titer and MAP1B immunoblot 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 patterns suggest collapsin response-mediator protein-5 (CRMP-5)-IgG, then the CRMP-5-IgG IFA titer and CRMP-5-IgG Western blot will be performed at an additional charge.

 

If the IFA pattern suggests adaptor protein 3 beta2 (AP3B2) antibody, then the AP3B2 antibody IFA titer and AP3B2 antibody CBA 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.

-Acquired Neuropathy Diagnostic Algorithm

Method Name

AIAEI: Technical Interpretation

 

AMPHS, AGN1S, ANN1S, ANN3S, APBIS, CRMS, PCAB2, AGNTS, AN1TS, AN3TS, APBTS, APHTS, CRMTS, IG5TS, PC2TS: Indirect Immunofluorescence Assay (IFA)

 

CS2CS, IG5CS, LG1CS, APBCS: Cell Binding Assay (CBA)

 

CRMWS: Western Blot (WB)

 

AGNBS, AMIBS, AN1BS, AN2BS, MP1BS: Immunoblot (IB)

Reporting Name

Axonal, Autoimm/Paraneo, S

Specimen Type

Serum

Specimen Minimum Volume

Serum: 2 mL

Specimen Stability Information

Specimen Type Temperature Time
Serum Refrigerated (preferred) 28 days
  Frozen  28 days
  Ambient  72 hours

Reject Due To

Gross hemolysis Reject
Gross lipemia Reject
Gross icterus Reject

Reference Values

Test ID

Reporting name

Methodology

Reference value

AIAEI

Autoimmune Axonal Interp, S

Technical interpretation

Interpretive report

AMPHS

Amphiphysin Ab, S

IFA

Negative

AGN1S

Anti-Glial Nuclear Ab, Type 1

IFA

Negative

ANN1S

Anti-Neuronal Nuclear Ab, Type 1

IFA

Negative

ANN3S

Anti-Neuronal Nuclear Ab, Type 3

IFA

Negative

APBIS

AP3B2 IFA, S

IFA

Negative

CS2CS

CASPR2-IgG CBA, S

CBA

Negative

CRMS

CRMP-5-IgG, S

IFA

Negative

IG5CS

IgLON5 CBA, S

CBA

Negative

LG1CS

LGI1-IgG CBA, S

CBA

Negative

PCAB2

Purkinje Cell Cytoplasmic Ab Type 2

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

APHTS

Amphiphysin Ab Titer, S

IFA

<1:240

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

CRMTS

CRMP-5-IgG Titer, S

IFA

<1:240

CRMWS

CRMP-5-IgG Western Blot, S

WB

Negative

IG5TS

IgLON5 IFA Titer, S

IFA

<1:240

MP1BS

MAP1B Immunoblot, S

IB

Negative

PC2TS

PCA-2 Titer, S

IFA

<1:240

 

*Methodology abbreviations:

Cell-binding assay (CBA)

Immunoblot (IB)

Immunofluorescence assay (IFA)

Western blot (WB)

Day(s) Performed

Profile tests: Monday through Sunday; Reflex tests: Varies

Report Available

8 to 12 days

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Test Classification

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

86255 x 10

84182 AGNBS (if appropriate)

86256 AGNTS (if appropriate)

86256 APHTS (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 CRMTS (if appropriate)

84182 CRMWS (if appropriate)

86256 IG5TS (if appropriate)

84182 MP1BS (if appropriate)

86256 PC2TS (if appropriate)

LOINC Code Information

Test ID Test Order Name Order LOINC Value
AIAES Axonal, Autoimm/Paraneo, S 94695-4

 

Result ID Test Result Name Result LOINC Value
606950 IgLON5 CBA, S 96478-3
615863 AP3B2 IFA, S 101907-4
89080 AGNA-1, S 84927-3
81722 Amphiphysin Ab, S 72327-0
80150 ANNA-1, S 33615-6
83137 ANNA-3, S 43102-3
83077 CRMP-5-IgG, S 72504-4
83138 PCA-2, S 84925-7
64279 LGI1-IgG CBA, S 94287-0
64281 CASPR2-IgG CBA, S 94285-4
606975 Autoimmune Axonal Interp, S 69048-7
618900 IFA Notes 48767-8