Acetylcholine Receptor Antibody Reflexive Panel
2001571
 
Ordering Recommendation
Preferred reflexive panel for diagnosing myasthenia gravis. Panel contains binding, blocking, and modulating antibodies.
Mnemonic
ACHR R PAN
Methodology
Quantitative Radioimmunoassay/Semi-Quantitative Flow Cytometry
Performed
Sun-Sat
Reported
3-7 days
New York DOH Approval Status
This test is New York DOH approved.
Specimen Required
Patient Preparation
 
Collect
Serum separator tube.  
Specimen Preparation
Separate serum from cells ASAP or within 2 hours of collection. Transfer 1 mL serum to an ARUP Standard Transport Tube. (Min: 0.5 mL)  
Storage/Transport Temperature
Refrigerated.  
Unacceptable Conditions
Contaminated, hemolyzed, or severely lipemic specimens.  
Remarks
 
Stability
After separation from cells: Ambient: 2 hours; Refrigerated: 2 weeks; Frozen: 1 year (avoid repeated freeze/thaw cycles)  
Reference Interval
Test Number Components Reference Interval
0080009Acetylcholine Receptor Binding Antibody Negative: 0.0-​0.4 nmol/L
Positive: 0.5 nmol/L or greater
0099580Acetylcholine Receptor Blocking Antibody Effective November 18, 2013
Negative: 0-​26% blocking
Indeterminate: 27-​41% blocking
Positive: 42% or greater blocking
0099521Acetylcholine Receptor Modulating Antibody Negative: 0-​45% modulating
Positive: 46% or greater modulating

Effective August 20, 2012
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.

See Compliance Statement B: www.aruplab.com/CS
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.
CPT Code(s)
83519; 83516; if reflexed, add 83516
Components
Component Test Code*Component Chart Name
0080009Acetylcholine Binding Antibody
0099580Acetylcholine Blocking Antibody
* Component test codes cannot be used to order tests. The information provided here is not sufficient for interface builds; for a complete test mix, contact interface support at interface.support@aruplab.com.
Cross References
  • AChR Antibody
  • AChR reflex panel
  • Muscle nicotinic Acetylcholine Receptor (AChR) Binding Antibody
  • Myasthenia Gravis Antibodies
  • Myasthenia Gravis Antibodies Reflex