Medical Necessity Documentation:
Client Notes:
Patient Preparation:
Specimen Requirements:
8.0 mL Serum from a Red Top Tube in a Plastic Vial
Collection Instructions:
Minimum Volume:
4.0 mL
Transport & Storage: Temperature/Stability:
24 hours Ambient
48 hours Refrigerated
21 days Frozen
Rejection Criteria:
Gross hemolysis, grossly lipemic, grossly icteric, turbid, bacterial contamination, received refrigerated, received ambient.
Reference Range:
Critical Ranges:
Test Comments:
If Paraneoplastic Expanded Ab Screen, Tissue IFA suggests one or more positive analytes, a line blot with 10 analytes will be performed: ANNA1 (Hu), ANNA2 (Ri), PCA1 (Yo), Ma2/Ta, CRMP5(CV2), Amphiphysin, AGNA1 (SOX1), GAD65, PCA Tr (DNER), and Zic4.
If the Paraneoplastic Expanded Ab Screen, Tissue IFA suggests ANNA3, titer will be performed.
If the Paraneoplastic Expanded Ab Screen, Tissue IFA suggests PCA-2, titer will be performed.
If the Paraneoplastic Expanded Ab Screen, Tissue IFA suggests PCA-Tr (DNER) and Neurology Antibody Line Blot shows PCA Tr (DNER) negative and PCA1 (Yo) negative, then Purkinje Cell Cytoplasmic Antibody Type Tr (DNER), CBA, IFA will be performed at an additional charge
If Purkinje Cell Cytoplasmic Antibody Type Tr (DNER), CBA, IFA is positive, titer will be performed.
If the Paraneoplastic Expanded Ab Screen, Tissue IFA for Myelin antibody is positive, then:
a. Myelin antibody IFA titer will be performed at an additional charge
b. Myelin Associated Glycoprotein (MAG) Antibody Western Blot will be performed at an additional charge
c. If Myelin Associated Glycoprotein (MAG) Antibody Western Blot is positive, then Myelin Associated Glycoprotein (MAG)-SGPG Antibody and Myelin Associated Glycoprotein (MAG) Antibody (IgM) EIA will be performed at an additional charge
If the Neurology Antibody, CBA is positive for NMDAR1, AMPAR2, LGI-1, or CASPR2, titers will be performed at an additional charge
If the Aquaporin 4 (AQP4) Ab, CBA, is positive, titer will be performed at an additional charge
If the Neurology Antibody, CBA is positive for AMPAR1 or GABA-B Receptor, titers will be performed.
If the DPPX Receptor Antibody, CBA is positive, titer will be performed.
Methodology:
based on individual tests
Clinical Significance:
Detection of antineuronal autoantibodies aids the diagnosis of autoimmune paraneoplastic syndromes, encephalopathies and other autoimmune neurological conditions. Identification of specific antineuronal autoantibodies may also help in the diagnostic workup for occult malignancies. Finally, knowledge of the specific identity of antineuronal autoantibodies aids greatly in making therapeutic decisions for patients. Antineuronal antibodies are detected and identified by indirect immunofluorescence, using multiple neuronal tissues, non-neuronal tissues, and transfected substrate cells, as well as radioimmunoassay's. Line blot assays are used for confirmatory reflex testing.
Documentation:
Custom Panel:
No
PRODUCTION SCHEDULE
Turn Around Time:
3 to 14 days
Days Performed:
Tuesday
Departments:
Sites Performed:
Quest - Chantilly to San Juan Capistrano
PHL Test Code:
PAEP
EPIC Test Code:
IMO5744
Send Out Test Code:
94957
Alternate Test Names:
Autoimmune Paraneoplastic Panel Reflex; Para Expanded Serum; Paraneoplastic Autoimmune Evaluation; PNS Expanded
Included Tests:
CPT Coding:
96255(x19), 86052, 83519 (x2), 86341 (CDM 00910022(x19),00910023(x2),00910002,00910003,00910004,00910001