Acetylcholine Receptor Antibody Reflexive Panel
Ordering Recommendation
Preferred reflexive panel for diagnosing myasthenia gravis. Includes acetylcholine receptor (AChR) binding and blocking antibodies with reflex to AChR modulating antibodies.
New York DOH Approval Status
Specimen Required
Serum Separator Tube (SST).
Separate from cells ASAP or within 2 hours of collection. Transfer 1 mL serum to an ARUP Standard Transport Tube. (Min: 0.5 mL)
Refrigerated.
Contaminated, hemolyzed, or severely lipemic specimens.
After separation from cells: Ambient: 48 hours; Refrigerated: 2 weeks; Frozen: 1 year (avoid repeated freeze/thaw cycles)
Methodology
Quantitative Radioimmunoassay/Semi-Quantitative Flow Cytometry
Performed
Sun-Sat
Reported
3-7 days
Reference Interval
Test Number |
Components |
Reference Interval |
---|---|---|
Acetylcholine Binding Antibody | 0.4 nmol/L or less | |
Acetylcholine Blocking Antibody | 26 or less blocking |
Interpretive Data
Approximately 85-90 percent of patients with myasthenia gravis (MG) express antibodies to the acetylcholine receptor (AChR), which can be divided into binding, blocking, and modulating antibodies. Binding antibody can activate complement and lead to loss of AChR. Blocking antibody may impair binding of acetylcholine to the receptor, leading to poor muscle contraction. Modulating antibody causes receptor endocytosis resulting in loss of AChR expression, which correlates most closely with clinical severity of disease. Approximately 10-15 percent of individuals with confirmed myasthenia gravis have no measurable binding, blocking, or modulating antibodies.
This test was developed and its performance characteristics determined by ARUP Laboratories. It has not been cleared or approved by the US Food and Drug Administration. This test was performed in a CLIA certified laboratory and is intended for clinical purposes.
Component | Interpretation | |
---|---|---|
Acetylcholine Receptor Binding Antibody | Negative: Positive: |
0.0-0.4 nmol/L 0.5 nmol/L or greater |
Acetylcholine Receptor Blocking Antibody | Negative: Indeterminate: Positive: |
0-26% blocking 27-41% blocking 42% or greater blocking |
Laboratory Developed Test (LDT)
Note
If Acetylcholine Receptor Binding Antibody result is greater than 0.4 nmol/L or Acetylcholine Receptor Blocking Antibody result is greater than 26 percent, then Acetylcholine Receptor Modulating Antibody (ARUP test code 0099521) will be added. Additional charges apply.
Hotline History
CPT Codes
86041; 86042; if reflexed, add 86043
Components
Component Test Code* | Component Chart Name | LOINC |
---|---|---|
0080009 | Acetylcholine Binding Antibody | 11034-6 |
0099580 | Acetylcholine Blocking Antibody | 42937-3 |
Aliases
- AChR Antibody
- AChR reflex panel
- Muscle nicotinic Acetylcholine Receptor (AChR) Binding Antibody
- Myasthenia Gravis Antibodies
- Myasthenia Gravis Antibodies Reflex