Aquaporin-4 Receptor Antibody by ELISA with Reflex to Aquaporin-4 Receptor Antibody, IgG by IFA
Ordering Recommendation

For evaluation of optic neuritis, acute myelitis, spinal cord lesions, or autoimmune encephalitis.

Semi-Quantitative Enzyme-Linked Immunosorbent Assay/ Semi-Quantitative Indirect Fluorescent Antibody
Tue, Thu
1-6 days
New York DOH Approval Status
This test is New York DOH approved.
Submit With Order
ARUP Consult®
Disease Topics
Specimen Required
Patient Preparation
Serum Separator Tube (SST). 
Specimen Preparation
Separate from cells ASAP or within 2 hours of collection. Transfer 1 mL serum to an ARUP Standard Transport Tube. (Min: 0.3 mL) 
Storage/Transport Temperature
Unacceptable Conditions
Amniotic fluid, CSF, pericardial fluid, ocular fluid, peritoneal fluid, synovial fluid, or plasma. Contaminated, hemolyzed, icteric, or lipemic specimens. 
After separation from cells: Ambient: 72 hours; Refrigerated: 2 weeks; Frozen: 1 month (avoid repeated freeze/thaw cycles) 
Reference Interval
Test Number
Reference Interval
2003036Aquaporin-4 Receptor AntibodyEffective October 3, 2016
Negative2.9 U/mL or less
Positive3.0 U/mL or greater

2013320Aquaporin-4 Receptor Antibody, IgG by IFA with Reflex to Titer, SerumLess than 1:10

Interpretive Data
Approximately 75 percent of patients with neuromyelitis optica (NMO) express antibodies to the aquaporin-4 (AQP4) receptor. Diagnosis of NMO requires the presence of longitudinally extensive acute myelitis (lesions extending over 3 or more vertebral segments) and optic neuritis. While absence of antibodies to the AQP4 receptor does not rule out the diagnosis of NMO, presence of this antibody is diagnostic for NMO.

If AQP4 antibody IgG by ELISA is positive, then AQP4 antibody IgG by IFA will be added. If AQP4 antibody IgG by IFA is positive, then an AQP4 antibody IgG titer will be added. Additional charges apply.
Hotline History
CPT Code(s)
83516; if reflexed, add 86255; if reflexed, add 86256
Component Test Code*Component Chart NameLOINC
2003121Aquaporin-4 Receptor Antibody61430-5
* 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 view this test within the Laboratory Test Directory found at