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.
Specimen Required
Patient Preparation
Collect

Serum Separator Tube (SST)

Specimen Preparation

Separate from cells ASAP or within 2 hours of collection. Transfer three 1 mL serum aliquots to ARUP Standard Transport Tubes. (Min: 0.5 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
0050746 Striated Muscle Antibodies, IgG with Reflex to Titer Less than 1:40
2004221 N-methyl-D-Aspartate Receptor Antibody, IgG, Serum with Reflex to Titer < 1:10
2001771 Glutamic Acid Decarboxylase Antibody 0.0-5.0 IU/mL
2013956 CV2.1 Screen by IFA with Reflex to Titer Less than 1:10
0092628 P/Q-Type Voltage-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

2005636 Titin 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

2004890 Voltage-Gated Potassium Channel (VGKC) Antibody, Serum
Negative 31 pmol/L or less
Indeterminate 32-87 pmol/L
Positive 88 pmol/L or greater

2003036 Aquaporin-4 Receptor Antibody Effective October 3, 2016
Negative 2.9 U/mL or less
Positive 3.0 U/mL or greater

0080009 Acetylcholine Receptor Binding Antibody
Negative 0.0-0.4 nmol/L
Positive 0.5 nmol/L or greater

2007961 Paraneoplastic Antibodies (PCCA/ANNA) by IFA with Reflex to Titer and Immunoblot
Test Number
Components
Reference Interval
Purkinje Cell/Neuronal Nuclear IgG Scrn None Detected
Neuronal Nuclear Antibody (ANNA) IFA Titer, IgG Less than 1:10
Purkinje Cell Antibody, Titer Less than 1:10
2007963 Neuronal Nuclear Antibodies (Hu, Ri, Yo) IgG by Immunoblot (INACTIVE as of 08/17/20: Refer to 3002917 in the August Hotline) Refer to report

2008893 Amphiphysin Antibody, IgG Negative
2013320 Aquaporin-4 Receptor Antibody, IgG by IFA with Reflex to Titer, Serum Less than 1:10
2009456 Leucine-Rich, Glioma-Inactivated Protein 1 Antibody, IgG with Reflex to Titer, Serum Less than 1:10
2009452 Contactin-Associated Protein-2 Antibody, IgG with Reflex to Titer, Serum Less than 1:10
0099521 Acetylcholine Receptor Modulating Antibody Effective August 20, 2012
Negative 0-45% modulating
Positive 46% or greater modulating

  N-Type Calcium Channel Antibody
Negative 0.0 to 69.9 pmol/L
Indeterminate 70.0 to 110.0 pmol/L
Positive 110.1 pmol/L or greater

3001260 Alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionic Acid (AMPA) Receptor Antibody, IgG by IFA with Reflex to Titer, Serum Less than 1:10
3001270 Gamma Aminobutyric Acid Receptor, Type B (GABA-BR) Antibody, IgG by IFA with Reflex to Titer, Serum Less than 1:10
3001277 Myelin Oligodendrocyte Glycoprotein (MOG) Antibody, IgG by IFA with Reflex to Titer, Serum Less than 1:10

Interpretive Data

Refer to Report

Compliance Statement D: For laboratory tests using a manufactured RUO kit. 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 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.
If LGI1 antibody IgG is positive, then LGI1 antibody IgG titer will be added. Additional charges apply.
If CASPR2 antibody IgG is positive, then CASPR2 antibody IgG titer will be added. Additional charges apply.
If Alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionic Acid (AMPA) Receptor Antibody, IgG by IFA with Reflex to Titer, Serum is positive, then an Alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionic Acid (AMPA) Receptor Antibody Titer, IgG, Serum is reported. Additional charges apply.
If Gamma Aminobutyric Acid Receptor, Type B (GABA-BR) Antibody, IgG by IFA with Reflex to Titer, Serum is positive, then a Gamma Aminobutyric Acid Receptor, Type B (GABA-BR) Antibody Titer, IgG, Serum is performed. Additional charges apply.
If Myelin Oligodendrocyte Glycoprotein (MOG) Antibody, IgG by IFA with Reflex to Titer, Serum is positive, then a Myelin Oligodendrocyte Glycoprotein (MOG) Antibody Titer, IgG is performed. Additional charges apply.

Hotline History
N/A
CPT Codes

83519 x4; 83516 x3; 86255 x9; 86341; if reflexed add 86256; if reflexed add 86256; if reflexed add 86256; if reflexed add 86255 if further reflexed add 86256; if reflexed add 83516; if reflexed add 83516 and/or 86256; if reflexed, add 86256; if reflexed, add 86256; if reflexed, add 86256; if reflexed, add 86256; if reflexed, add 86256; if reflexed add 86256.

Components
Component Test Code* Component Chart Name LOINC
0050747 Striated Muscle Antibodies, IgG Screen 49692-7
0051709 Neuronal Antibody (Amphiphysin) 57749-4
0080009 Acetylcholine Binding Antibody 11034-6
0092629 P/Q-Type Calcium Channel Antibody 33980-4
2001772 Glutamic Acid Decarboxylase Antibody 56540-8
2003121 Aquaporin-4 Receptor Antibody 61430-5
2004222 N-methyl-D-Aspartate Receptor Ab, Serum 80221-5
2004890 Voltage-Gated Potassium Channel Ab, Ser 41871-5
2005637 Titin Antibody
2007962 Purkinje Cell/Neuronal Nuclear IgG Scrn 61177-2
2009453 CASPR2 Ab IgG Screen by IFA, Serum 82979-6
2009457 LGI1 Ab IgG Screen by IFA, Serum 82978-8
2013959 CV2.1 Antibody IgG Screen by IFA
3001261 AMPA Receptor Ab IgG Screen, Serum 82733-7
3001271 GABA-B Receptor Ab IgG Screen, Serum 82977-0
3001278 MOG Antibody IgG Screen, Serum 91545-4
3002047 N-Type Calcium Channel Antibody 33979-6
* 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
Autoimmune Neurologic Disease Reflexive Panel, Serum