Ordering Recommendation

Use to screen for IgG paraneoplastic pemphigus antibodies by indirect immunofluorescence using rat bladder and other rodent substrates. If not yet performed, testing for IgG envoplakin antibodies should also be ordered; refer to Envoplakin Antibody, IgG by ELISA (3016533). 

Panel testing that includes IgG envoplakin antibodies by ELISA is preferred; refer to Paraneoplastic Pemphigus (Paraneoplastic Autoimmune Multiorgan Syndrome) Expanded Antibody Panel by IIF With ELISA (3016534).

Results should be correlated with Direct Immunofluorescence, Tissue Biopsy (Cutaneous, Mucosal, Epithelial) (0092572); histopathological examination of formalin-fixed tissue; and assessment of other epithelial antibodies. 

For comprehensive testing, order with: 
•    Immunobullous Disease Antibody Panel (3001409). 

Alternatively, to assess for specific disease-associated antibodies or individual antibody targets, order with: 
•    Pemphigus Antibody Panel, IgG (0090650),
•    Pemphigus Antibodies, IgA by IIF (0092106), and
•    Basement Membrane Zone Antibody Panel (3001410
•    Desmoglein 1 and Desmoglein 3 (Pemphigus) Antibodies, IgG by ELISA (0090649),
•    Bullous Pemphigoid (BP180 and BP230) Antibodies, IgG by ELISA (0092566), and
•    Collagen Type VII Antibody, IgG by ELISA (2010905).

For more information about components, methodology, and specimen type, refer to the ARUP Immunobullous Disease Testing Comparison tool.

New York DOH Approval Status

This test is New York state approved.

Specimen Required

Patient Preparation

Plain red or serum separator tube (SST).

Specimen Preparation

Transfer 2 mL serum to an ARUP standard transport tube. (Min: 0.5 mL)

Storage/Transport Temperature


Unacceptable Conditions

Hemolyzed or lipemic specimens. Plasma.


Ambient: 1 week; Refrigerated: 2 weeks; Frozen: Indefinitely


Semi-Quantitative Indirect Immunofluorescence (IIF)




3-7 days

Reference Interval

By report

Interpretive Data

Refer to report

Compliance Category

Performed by non-ARUP Laboratory


The methodology is indirect immunofluorescence (IIF) of patient serum on substrates from rodents including rat bladder, mouse bladder, mouse heart, and mouse liver to detect characteristic antibody reactivity: simple columnar epithelial cell surface and basement membrane zone in bladders, intercalated discs in heart, and portal tracts in liver. Monkey esophagus substrate is included if other concurrent IIF testing does not. For specimens less than 0.5 mL, call the Immunodermatology Laboratory at 866-266-5699.

This test should be distinguished from antibody testing of cerebral spinal fluid (CSF) for paraneoplastic neurologic syndromes; 3004510, 3004512, 3004517 are different tests.

Hotline History


CPT Codes

88346; 88350 x4


Component Test Code* Component Chart Name LOINC
0092107 Paraneoplastic Pemphigus Ab Screen 42936-5
3004041 EER Paraneoplastic Pemphigus Ab Screen 10865-4
* 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.


  • cell surface and basement membrane zone antibodies
  • envoplakin antibodies
  • intercellular substance
  • mixed epithelial antibodies
  • paraneoplastic autoimmune multiorgan syndrome (PAMS)
  • Paraneoplastic Pemphigus Antibody Screen
  • periplakin antibodies
  • PNP
  • rat bladder immunofluorescence
Paraneoplastic Pemphigus (Paraneoplastic Autoimmune Multiorgan Syndrome) Screening Antibodies by IIF