Muscle Weakness Autoimmune Reflexive Panel
2005640
 
Ordering Recommendation
Acceptable reflexive panel for diagnosing myasthenia gravis. Panel contains binding, blocking, and modulating antibodies; voltage-gated calcium and potassium channels; titin antibody; and SMA IgG screen with titer.
Mnemonic
MUWA R PAN
Methodology
Quantitative Radioimmunoassay/Qualitative Radiobinding Assay/Semi-Quantitative Flow Cytometry/Semi-Quantitative Indirect Fluorescent Antibody
Performed
Refer to individual components
Reported
2-8 days
New York DOH Approval Status
This test is New York DOH approved.
Specimen Required
Patient Preparation
 
Collect
Serum separator tube (SST).  
Specimen Preparation
Separate serum from cells ASAP or within 2 hours of collection. Transport 2 mL serum. (Min: 1 mL)  
Storage/Transport Temperature
Refrigerated.  
Unacceptable Conditions
Plasma. Contaminated, hemolyzed, or severely lipemic specimens.  
Remarks
 
Stability
Ambient: 48 hours; Refrigerated: 2 weeks; Frozen: 1 year  
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
0092628Voltage-​Gated Calcium Channel (VGCC) Antibody Effective November 14, 2011
Negative 0.0 to 24.5 pmol/L
Indeterminate 24.6 to 45.6 pmol/L
Positive 45.7 pmol/L or greater
2004890Voltage-​Gated Potassium Channel (VGKC) Antibody Effective April 18, 2011
Negative 31 pmol/L or less
Indeterminate 32-​87 pmol/L
Positive 88 pmol/L or greater
2005636Titin Antibody Effective January 17, 2012
Titin Antibody
Negative 0.00-​0.45 IV
Indeterminate 0.46-​0.71 IV
Positive 0.72 IV or greater
0050746Striated Muscle Antibody, IgG with Reflex to Titer Screen: < 1:40 No antibody detected.
Titer: < 1:40 No antibody detected.
Interpretive Data
In early-onset myasthenia gravis patients with anti-acetylcholine receptor antibodies, the presence of titin antibody indicates a 95-100 percent likelihood of an underlying thymoma.

Refer to Statement B under Testing Information at http://www.aruplab.com.

See Compliance Statement D: 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 will be added. If Striated Muscle Ab is greater than or equal to 1:40, then a titer will be added. Additional charges apply.
CPT Code(s)
83519; 83516; if reflexed, add 83516 x2; 83519 x2; 86255; if reflexed, add 86256
Components
Component Test Code*Component Chart Name
0050747Striated Muscle Antibody, IgG Screen
0050748Striated Muscle Antibody, IgG Titer
0080009Acetylcholine Binding Antibody
0092629Voltage-Gated Calcium Channel (VGCC) Ab
0099580Acetylcholine Blocking Antibody
2004890Voltage-Gated Potassium Channel (VGKC)Ab
2005637Titin 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 Binding Antibody
  • AChR Antibody
  • Anti-Skeletal Muscle IgG Antibodies
  • Anti-Striated Antibody
  • anti-tintin Ab
  • Muscle (Skeletal) Antibodies
  • Muscle nicotinic Acetylcholine Receptor
  • Myasthenia Gravis Antibodies
  • Myoid Antibody
  • Skeletal Muscle Antibodies
  • Striational Antibodies
  • VGCC Ab
  • VGKC Ab
  • Voltage-Gated Calcium Channel Antibody
  • Voltage-Gated Potassium Channel Antibody