Ordering Recommendation

Differential evaluation of encephalitis of unknown origin with subacute onset of seizures, confusion, memory loss, and/or behavioral change. Serum is the preferred specimen; refer to Autoimmune Encephalitis Reflexive Panel, Serum (2013601). For adults and patients with suspicion of cancer, additional evaluation of paraneoplastic autoantibodies is recommended; refer to Paraneoplastic Antibodies (PCCA/ANNA) by IFA with Reflex to Titer and Immunoblot, CSF (2010841).

Mnemonic
AENCEPHCSF
Methodology

Semi-Quantitative Indirect Fluorescent Antibody/Quantitative Radioimmunoassay/Semi-Quantitative Enzyme-Linked Immunosorbent Assay

Performed

Tue

Reported

3-10 days

New York DOH Approval Status
Specimens from New York clients will be sent out to a New York DOH approved laboratory, if possible.
Specimen Required
Patient Preparation
Collect

CSF

Specimen Preparation

Transfer three (3) 1 mL CSF aliquots to ARUP Standard Transport Tubes. (Min: 0.5 mL/aliquot)

Storage/Transport Temperature

Frozen.

Unacceptable Conditions

Contaminated specimens.

Remarks
Stability

Ambient: 24 hours; Refrigerated: 1 week; Frozen: 1 month (avoid repeated freeze/thaw cycles)

Reference Interval
Test Number
Components
Reference Interval
3002788 Glutamic Acid Decarboxylase Antibody, CSF 0.0-5.0 IU/mL
2005164 N-methyl-D-Aspartate Receptor Antibody, IgG, CSF with Reflex to Titer Effective May 21, 2012
< 1:1
2011699 Aquaporin-4 Receptor Antibody, IgG by IFA, CSF with Reflex to Titer less than 1:1
3001257 Alpha-Amino-3-hydroxy-5-methyl-4-isoxazolepropionic Acid (AMPA) Receptor Antibody, IgG by IFA with Reflex to Titer, CSF Less than 1:1
3001267 Gamma Aminobutyric Acid Receptor, Type B (GABA-BR) Antibody, IgG by IFA with Reflex to Titer, CSF Less than 1:1
3001387 Voltage-Gated Potassium Channel (VGKC) Antibody, CSF
Negative 0.0-1.1 pmol/L
Positive 1.2 pmol/L or greater

3001986 Contactin-Associated Protein-2 Antibody, IgG with Reflex to Titer, CSF Less than 1:1
3001992 Leucine-Rich, Glioma-Inactivated Protein 1 Antibody, IgG with Reflex to Titer, CSF Less than 1:1

Interpretive Data

Refer to report.

Compliance Category

Laboratory Developed Test (LDT)

Note

If NMDA CSF antibody IgG is positive, then an NMDA CSF antibody IgG titer is reported. Additional charges apply.
If AQP4 antibody IgG is positive, then an AQP4 antibody IgG titer is reported. Additional charges apply.
If Alpha-Amino-3-hydroxy-5-methyl-4-isoxazolepropionic Acid (AMPA) Receptor Antibody, IgG by IFA with Reflex to Titer, CSF IgG is positive, then an Alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionic Acid (AMPA) Receptor Antibody Titer, IgG, CSF is reported. Additional charges apply.
If Gamma Aminobutyric Acid Receptor, Type B (GABA-BR) Antibody, IgG by IFA with Reflex to Titer, CSF is positive, then a Gamma Aminobutyric Acid Receptor, Type B (GABA-BR) Antibody Titer, IgG, CSF is performed. Additional charges apply.
If CASPR2 antibody IgG is positive, then CASPR2 antibody IgG titer will be added. Additional charges apply.
If LGI1 antibody IgG is positive, then LGI1 antibody IgG titer will be added. Additional charges apply.

Hotline History
N/A
CPT Codes

86255; if reflexed, add 86256
86255; if reflexed, add 86256
86255; if reflexed, add 86256
86255; if reflexed, add 86256
83519
86341
86255; if reflexed, add 86256
86255; if reflexed, add 86256

Components
Component Test Code* Component Chart Name LOINC
2005165 N-methyl-D-Aspartate Receptor Ab, CSF 80220-7
2011700 Neuromyelitis Optica/AQP4-IgG, CSF 46718-3
3001258 AMPA Receptor Ab IgG Screen, CSF 82732-9
3001268 GABA-B Receptor Ab IgG Screen, CSF 82984-6
3001388 Voltage-Gated Potassium Channel Ab, CSF 68913-3
3001987 CASPR2 Ab IgG Screen by IFA, CSF 90820-2
3001991 LGI1 Ab IgG Screen by IFA, CSF 90830-1
3002789 Glutamic Acid Decarboxylase Antibody CSF 42501-7
* 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 Encephalitis Reflexive Panel, CSF