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Autoimmune Neurologic Disease Reflexive Panel
2013944
Ordering Recommendation

Comprehensive panel for the evaluation of paraneoplastic and neuromuscular junction disorders, and/or encephalitis, in the presence or absence of malignancy.

Mnemonic
NEURO R
Methodology
Semi-Quantitative Indirect Fluorescent Antibody/Qualitative Immunoblot/Quantitative Radioimmunoassay/Semi-quantitative Enzyme-Linked Immunosorbent Assay
Performed
Tue
Reported
3-10 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 (SST) 
Specimen Preparation
Separate from cells ASAP or within 2 hours of collection. Transfer three 3 mL serum aliquots to ARUP Standard Transport Tubes. (Min: 1.50 mL/aliquot) 
Storage/Transport Temperature
Frozen 
Unacceptable Conditions
Amniotic fluid, ocular fluid, peritoneal fluid, synovial fluid, CSF, or plasma. Contaminated, hemolyzed, icteric, or lipemic specimens. 
Remarks
 
Stability
After separation from cells: Ambient: 24 hours; Refrigerated: 1 week; Frozen: 1 month (avoid repeated freeze/thaw cycles) 
Reference Interval
Test Number
Components
Reference Interval
0050746Striated Muscle Antibodies, IgG with Reflex to TiterLess than 1:40
2004221N-methyl-D-Aspartate Receptor Antibody, IgG, Serum with Reflex to Titer< 1:10
2001771Glutamic Acid Decarboxylase Antibody0.0-5.0 IU/mL
2013956CV2.1 Screen by IFA with Reflex to TiterLess than 1:10
0092628Voltage-Gated Calcium Channel (VGCC) AntibodyEffective November 14, 2011
Negative0.0 to 24.5 pmol/L
Indeterminate24.6 to 45.6 pmol/L
Positive45.7 pmol/L or greater

2005636Titin AntibodyEffective January 17, 2012
Titin Antibody
Negative0.00-0.45 IV
Indeterminate0.46-0.71 IV
Positive0.72 IV or greater

2004890Voltage-Gated Potassium Channel (VGKC) Antibody
Negative31 pmol/L or less
Indeterminate32-87 pmol/L
Positive88 pmol/L or greater

2003036Aquaporin-4 Receptor AntibodyEffective October 3, 2016
Negative2.9 U/mL or less
Positive3.0 U/mL or greater

0080009Acetylcholine Receptor Binding Antibody
Negative0.0-0.4 nmol/L
Positive0.5 nmol/L or greater

2007961Paraneoplastic Antibodies (PCCA/ANNA) by IFA with Reflex to Titer and Immunoblot
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 ImmunoblotRefer to report

2008893Amphiphysin Antibody, IgGNegative

Interpretive Data
Refer to Report

Compliance Statement D: 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
If Striated Muscle Ab is detected, then a titer will be added. Additional charges apply.
If N-methyl-D-Aspartate Receptor Antibody is positive, then titer will be added. Additional charges apply.
If CV2.1 Antibody IgG Screen by IFA is positive, then a titer will be added. Additional charges apply.
If Aquaporin-4 Receptor Antibody IgG by ELISA is positive, then Aquaporin-4 Receptor Antibody, IgG by IFA will be added. If positive, then a titer will be added. Additional charges apply.
If Voltage-Gated Calcium Channel (VGCC) Antibody is Indeterminate or Positive, then Leucine-Rich, Glioma-Inactivated Protein 1 Antibody IgG and Contactin-Associated Protein-2 Antibody IgG will be added. If LGI1 antibody IgG is positive, then LGI1 antibody IgG titer will be added. If CASPR2 antibody IgG is positive, then CASPR2 antibody IgG titer will be added. Additional charges apply.
If Acetylcholine Receptor Binding Antibody result is greater than 0.4 nmol/L then Acetylcholine Receptor Modulating Antibody will be added. Additional charges apply.
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.
CPT Code(s)
83519 x3; 83516 x4; 86255 x4; if reflexed add 86256; if reflexed add 86256; if reflexed add 86256; if reflexed add 86255 if further reflexed add 86256; if reflexed add 86255 x2 if further reflexed add 86256 per titer; if reflexed add 83516; if reflexed add 83516 and/or 86256
Components
Component Test Code*Component Chart NameLOINC
0050747Striated Muscle Antibodies, IgG Screen49692-7
0051709Neuronal Antibody (Amphiphysin)57749-4
0080009Acetylcholine Binding Antibody11034-6
0092629Voltage-Gated Calcium Channel (VGCC) Ab33980-4
2001772Glutamic Acid Decarboxylase Antibody56540-8
2003121Aquaporin-4 Receptor Antibody61430-5
2004222N-methyl-D-Aspartate Receptor Ab, Serum80221-5
2004890Voltage-Gated Potassium Channel (VGKC)Ab41871-5
2005637Titin Antibody
2007962Purkinje Cell/Neuronal Nuclear IgG Scrn61177-2
2013959CV2.1 Antibody IgG Screen by IFA
* 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