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Motor and Sensory Neuropathy Evaluation with Immunofixation Electrophoresis and Reflex to Titer and Neuronal Immunoblot (Testing Alert as of 03/17/18: Refer to Note for details)
2007967
Ordering Recommendation

Aid in diagnosis of combined motor/sensory neuropathy with suspicion for plasma cell dyscrasia or suspicion for other malignancy.

Mnemonic
MSNCR
Methodology
Semi-Quantitative Enzyme-Linked Immunosorbent Assay/Semi-Quantitative Indirect Fluorescent Antibody/Qualitative Immunoblot/Quantitative Nephelometry/Quantitative Capillary Electrophoresis/Qualitative Immunofixation Electrophoresis
Performed
Refer to individual components
Reported
3-9 days
New York DOH Approval Status
This test is New York DOH approved.
Submit With Order
ARUP Consult®
Disease Topics
Specimen Required
Patient Preparation
 
Collect
Serum separator tube 
Specimen Preparation
Separate serum from cells ASAP or within 2 hours of collection. Transfer 4 mL serum to an ARUP Standard Transport Tube. (Min: 2 mL) 
Storage/Transport Temperature
Refrigerated 
Unacceptable Conditions
Plasma, CSF, or other body fluids. Contaminated, heat-inactivated, hemolyzed, severely icteric, or lipemic specimens. 
Remarks
 
Stability
Ambient: Unacceptable; Refrigerated: 2 weeks; Frozen: 1 year 
Reference Interval
Effective February 16, 2016
Test Number
Components
Reference Interval
Purkinje Cell/Neuronal Nuclear IgG ScrnNone Detected
Neuronal Nuclear Antibody (ANNA) IFA Titer, IgGLess than 1:10
Purkinje Cell Antibody, TiterLess than 1:10
2007963Neuronal Nuclear Antibodies (Hu, Ri, Yo) IgG by ImmunoblotNone Detected
0051285Myelin Associated Glycoprotein (MAG) Antibody, IgMLess than 1000 TU
0051284Sulfate-3-Glucuronyl Paragloboside (SGPG) Antibody, IgMLess than 1.00 IV
Asialo-GM1 Antibodies, IgG/IgM29 IV or less: Negative
30-50 IV: Equivocal
51-100 IV: Positive
101 IV or greater: Strong Positive
GM1 Antibodies, IgG/IgM29 IV or less: Negative
30-50 IV: Equivocal
51-100 IV: Positive
101 IV or greater: Strong Positive
GD1a Antibodies, IgG/IgM29 IV or less: Negative
30-50 IV: Equivocal
51-100 IV: Positive
101 IV or greater: Strong Positive
GD1b Antibodies, IgG/IgM29 IV or less: Negative
30-50 IV: Equivocal
51-100 IV: Positive
101 IV or greater: Strong Positive
GQ1b Antibodies, IgG/IgM29 IV or less: Negative
30-50 IV: Equivocal
51-100 IV: Positive
101 IV or greater: Strong Positive
Total Protein-Electrophoresis, Serum6.00-8.30 g/dL
Albumin3.75-5.01 g/dL
Alpha-1 Globulins0.19-0.46 g/dL
Alpha-2 Globulins0.48-1.05 g/dL
Beta Globulins0.48-1.10 g/dL
Gamma0.62-1.51 g/dL
0050340Immunoglobulin AEffective February 16, 2016
0-30 days: 1-7 mg/dL
1 month: 1-53 mg/dL
2 months: 3-47 mg/dL
3 months: 5-46 mg/dL
4 months: 4-72 mg/dL
5 months: 8-83 mg/dL
6 months: 8-67 mg/dL
7-8 months: 11-89 mg/dL		9-11 months: 16-83 mg/dL
1 year: 14-105 mg/dL
2 years: 14-122 mg/dL
3 years: 22-157 mg/dL
4 years: 25-152 mg/dL
5-7 years: 33-200 mg/dL
8-9 years: 45-234 mg/dL
10 years and older: 68-408 mg/dL

0050350Immunoglobulin G
0- 30 days: 611-1542 mg/dL              
1 month: 241-870 mg/dL                          
2 months: 198-577 mg/dL            
3 months: 169-558 mg/dL                    
4 months: 188-536 mg/dL                          
5 months: 165-781 mg/dL                          
6 months: 206-676 mg/dL                           
7-8 months: 208-868 mg/dL                        		9-11 months: 282-1026 mg/dL
1 year: 331-1164 mg/dL
2 years: 407-1009 mg/dL
3 years: 423-1090 mg/dL
4 years: 444-1187 mg/dL
5-7 years: 608-1229 mg/dL
8-9 years: 584-1509 mg/dL
10 years and older: 768-1632 mg/dL

0050355Immunoglobulin MEffective February 16, 2016
0-30 days: 0-24 mg/dL                     
1 month: 19-83 mg/dL                                
2 months: 16-100 mg/dL                          
3 months: 23-85 mg/dL                               
4 months: 26-96 mg/dL                             
5 months: 31-103 mg/dL                            
6 months: 33-97 mg/dL                               
7-8 months: 32-120 mg/dL                         		9-11 months: 39-142 mg/dL
1 year: 41-164 mg/dL
2 years: 46-160 mg/dL
3 years: 45-190 mg/dL
4 years: 41-186 mg/dL
5-7 years: 46-197 mg/dL
8-9 years: 49-230 mg/dL
10 years and older: 35-263 mg/dL


Interpretive Data


Compliance Statement D: For laboratory tests using a manufactured RUO kit. This test was developed and its performance characteristics determined by ARUP Laboratories. The U. S. Food and Drug Administration has not approved or cleared this test; however, FDA clearance or approval is not currently required for clinical use. The results are not intended to be used as the sole means for clinical diagnosis or patient management decisions.

Note
The Asialo-GM1 Antibodies, IgG/IgM component of this test is unavailable due to a nationwide manufacturer reagent issue. The result of this individual component alone has minimal clinical significance but can support an overall clinical diagnosis in conjunction with other clinical parameters and/or other motor neuropathy markers. The other panel components are not affected by this reagent issue and will be reported within the published turn-around time.

Purkinje Cell (PCCA) antibody and Neuronal Nuclear (ANNA) antibody IgG are screened by IFA. If the IFA screen is indeterminate, then a Neuronal Nuclear Antibodies (Hu, Ri, and Yo) IgG by Immunoblot will be added. If the IFA screen is positive at 1:10 or greater, then a PCCA/ANNA antibodies titer and Neuronal Nuclear Antibodies (Hu, Ri, and Yo) IgG by Immunoblot will be added. Additional charges apply.
Hotline History
N/A
CPT Code(s)
83516 x 7; 84160; 82784 x3; 84165; 86334; 86255; if reflexed add 83516 and/or 86256
Components
Component Test Code*Component Chart NameLOINC
0050020Albumin2862-1
0050035Alpha 1 Globulin2865-4
0050060Alpha 2 Globulin2868-8
0050110Beta Globulin2871-2
0050270Gamma2874-6
0050271Immunofixation25700-6
0050340Immunoglobulin A2458-8
0050350Immunoglobulin G2465-3
0050355Immunoglobulin M2472-9
0050545Total Protein-Electrophoresis2885-2
0051034Asialo-GM1 Antibodies, IgG/IgM44737-5
0051035GM1 Antibodies, IgG/IgM63244-8
0051037GD1a Antibodies, IgG/IgM48656-3
0051038GD1b Antibodies, IgG/IgM26870-6
0051039GQ1b Antibodies, IgG/IgM31674-5
0051284SGPG Antibody, IgM31666-1
0051285MAG Antibody, IgM Elisa17314-6
2005168SPEP/IFE Interpretation49275-1
2007962Purkinje Cell/Neuronal Nuclear IgG Scrn61177-2
2012458EER Motor Sensory Neuropathy Comp
* Component test codes cannot be used to order tests. The information provided here is not sufficient for interface builds; for a complete test mix, please click the sidebar link to access the Interface Map.
Aliases