Paraneoplastic Autoantibody Evaluation, CSF




Test Mnemonic

PARCSF

CPT Codes

  • 86255 - QTY (9)

Includes

  • Anti-Neuronal Nuclear Ab Type 1
  • Anti-Neuronal Nuclear Ab Type 2
  • CRMP-5 IgG
  • Anti-Glial Nuclear Ab Type 1
  • Anti-Neuronal Nuclear Ab Type 3
  • Purkinje Cell Cytoplasmic Ab Type 1
  • Purkinje Cell Cytoplasmic Ab Type 2
  • Purkinje Cell Cytoplasmic Ab Type Tr
  • Amphiphysin Ab

Performing Laboratory

Mayo Clinic Dpt of Lab Med & Pathology

FDA Category

Laboratory Developed Test


Specimen Requirements

Volume Type Container Collect Temperature Transport Temperature Special Instructions
4 mLCerebrospinal fluid (CSF)Sterile container Refrigerated 

Minimum Specimen Requirements

Volume Type Container Collect Temperature Transport Temperature Special Instructions
2 mL     

Stability

Environmental Condition Description
Ambient72 hours
Refrigerated28 days
Frozen28 days

Days Performed

Mon - Sun

Turnaround Time

11 - 18 days

Methodology

Name Description
Cell Binding Assay (CBA), if indicated 
Immunoblot (IB) 
Immunoprecipitation 
Indirect Immunofluorescence Assay (IFA)  
Radioimmunoassay (RIA) 
Western Blot (WB), if indicated 

Reference Range

Special Info

Reflex algorithm: If indirect immunofluorescence assay (IFA) patterns suggest AGNA-1 Ab, AGNA-1 IB is performed at an additional cost. If IFA patterns suggest amphiphysin Ab, amphiphysin IB is performed at an additional cost. If IFA patterns suggest ANNA-1 Ab, ANNA-1 IB is performed at an additional cost. If IFA patterns suggest ANNA-2 Ab, ANNA-2 IB is performed at an additional cost. If IFA patterns suggest PCA-1 Ab, PCA-1 IB is performed at an additional cost. If IFA patterns suggest PCA-Tr Ab, PCA-Tr IB is performed at an additional cost. If IFA patterns suggest CRMP-5-IgG, CRMP-5-IgG Western blot is performed at an additional cost. If IFA patterns suggest GAD65 Ab, GAD65 Ab RIA is performed at an additional cost. If IFA patterns suggest neuronal voltage-gated potassium channel-complex autoantibody, VGKC-complex Ab IPA is performed at an additional cost. If VGKCC > 0.00 nmol/L, LGI1-IgG CBA, CSF (Leucine-Rich Glioma Inactivated Protein-1 IgG, CSF) and CASPR2-IgG CBA, CSF (Contactin-Associated Protein-Like-2-IgG, CSF) are performed at an additional cost. If IFA patterns suggest NMDA-Receptor Ab and NMDA-Receptor Ab CBA are positive, NMDA-Receptor Ab IF titer assay is performed at an additional cost. If IFA patterns suggest AMPA-Receptor Ab and AMPA-Receptor Ab CBA are positive, AMPA-Receptor Ab IF titer assay is performed at an additional cost. If IFA patterns suggest GABA-B-Receptor Ab and GABA-B-R Receptor Ab are positive, GABA-B-R Receptor Ab IF titer assay is performed at an additional cost. If IFA patterns suggest DPPX, DPPX Ab CBA and DPPX titer are performed at an additional cost. If IFA patterns suggest mGluR1, mGluR1 Ab CBA and mGluR1 titer are performed at an additional cost. Neuron-restricted patterns of IgG staining that do not fulfill criteria for amphiphysin, ANNA-1, ANNA-2, ANNA-3, AGNA-1, 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." Include name, number, address, and email of ordering physician. In patients with a history of tobacco use or other lung cancer risk, or if thymoma is suspected, Paraneoplastic Autoantibody Evaluation, Serum (PARNEO) is also recommended. Grossly hemolyzed, lipemic or icteric specimens will be rejected.

Clinical Info

Aids in the diagnosis of paraneoplastic neurological autoimmune disorders related to carcinoma of lung, breast, ovary, thymoma, or Hodgkin lymphoma.