Specimen Requirements

Alternate Specimen Requirements

Minimum Specimen Requirements

Stability

Days Performed

Sun - Sat

Turnaround Time

11 - 18 days

Methodology

Reference Range

Special Info

Reflex Algorithm: If IFA patterns suggest AGNA-1 Ab, AGNA-1 immunoblot is performed at an additional cost. If IFA patterns suggest amphiphysin Ab, amphiphysin immunoblot is performed at an additional cost. If IFA patterns suggest ANNA-1 Ab, ANNA-1 immunoblot is performed at an additional cost. If IFA patterns suggest ANNA-2 Ab, ANNA-2 immunoblot is performed at an additional cost. If IFA patterns suggest PCA-1 Ab, PCA-1 immunoblot is performed at an additional cost. If IFA patterns suggest PCA-Tr Ab, PCA-Tr immunoblot is performed at an additional cost. If client requests or 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 NMDA-R, NMDA-R Ab CBA and/or NMDA-R Ab IF Titer Assay is performed at an additional cost. If IFA patterns suggest AMPA-R, AMPA-R Ab CBA and/or AMPA-R Ab IF Titer Assay is performed at an additional cost. If IFA patterns suggest GABA-B-R, GABA-B-R Ab CBA and/or GABA-B-R Ab IF Titer Assay is performed at an additional cost. If IFA patterns suggest DPPX, DPPX Ab CBA and DPPX Ab titer are performed at an additional cost. If IFA patterns suggest mGluR1, mGluR1 Ab CBA and mGluR1 Ab titer are performed at an additional cost. If CRMP IFA is positive, ACh receptor binding Ab, CRMP-5-IgG Western blot will be performed at an additional cost. Testing should be requested in cases of subacute basal ganglionic disorders (chorea, Parkinsonism), cranial neuropathies (especially loss of vision, taste, or smell) and myelopathies. If VGKC >0.00, LGI1-IgG CBA, S (Leucine-Rich Glioma Inactivated Protein-1 IgG, Serum) and CASPR2-IgG CBA, S (Contactin-Associated Protein-Like-2-IgG, Serum) 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." Provide relevant clinical information and name, phone number, address, and email of ordering provider. Patient Prep: For optimal antibody detection, it is recommended to collect the specimen prior to initiation of immunosuppressant medication. This test should not be requested in patients who have recently received radioisotopes, therapeutically or diagnostically, because of potential assay interference. The specific waiting period before specimen collection will be dependent upon 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 for 1 week and assayed if sufficiently decayed, or canceled if radioactivity remains. Patient should have no general anesthetic or muscle-relaxant drugs in the previous 24 hours. Causes for specimen rejection: Grossly hemolyzed, grossly lipemic, grossly icteric.

Clinical Info

Note: Titers lower than 1:240 are detectable by recombinant CRMP-5 Western blot analysis. CRMP-5 WB will be done on request on stored serum (held 4 weeks). This supplemental testing is recommended in cases of chorea, vision loss, cranial neuropathy, and myelopathy. Call Cleveland Clinic Client Services at 216-444-5755 and ask them to call the Mayo Neuroimmunology Lab at 800-533-1710 to request CRMP-5 Western blot. This test should not be requested on 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 one week and assayed if sufficiently decayed, or canceled if radioactivity remains. The neuronal voltage-gated potassium channel antibody assay will not be performed for children (aged 18 years or younger) because normal values are not yet established for the pediatric population.