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Autoimmune Encephalitis Reflexive Panel, CSF (Change effective as of 02/21/2023: Refer to 3006049 in the Feb Hotline)
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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
Methodology
Semi-Quantitative Cell-Based Indirect Fluorescent Antibody/Quantitative Radioimmunoassay/Semi-Quantitative Enzyme-Linked Immunosorbent Assay
Performed
Tue
Reported
3-10 days
New York DOH Approval Status
Specimen Required
CSF
Transfer three (3) 1 mL CSF aliquots to ARUP Standard Transport Tubes. (Min: 0.5 mL/aliquot)
Frozen.
Contaminated specimens.
Ambient: 24 hours; Refrigerated: 1 week; Frozen: 1 month (avoid repeated freeze/thaw cycles)
Reference Interval
| Test Number |
Components |
Reference Interval |
|---|---|---|
| Glutamic Acid Decarboxylase Antibody CSF | 0.0-5.0 IU/mL | |
| N-methyl-D-Aspartate Receptor Ab, CSF | Less than 1:1 | |
| Neuromyelitis Optica/AQP4-IgG, CSF | Less than 1:1 | |
| AMPA Receptor Ab IgG Screen, CSF | Less than 1:1 | |
| GABA-B Receptor Ab IgG Screen, CSF | Less than 1:1 | |
| Voltage-Gated Potassium Channel Ab, CSF | 0.0-1.1 pmol/L | |
| CASPR2 Ab IgG Screen by IFA, CSF | Less than 1:1 | |
| LGI1 Ab IgG Screen by IFA, CSF | Less than 1:1 | |
| DPPX Ab IgG CBA IFA Screen, CSF | Less than 1:1 |
Interpretive Data
Refer to report.
| Component |
Interpretive Data |
|---|---|
| Voltage-Gated Potassium Channel Ab, CSF | 0.0-1.1 pmol/L: Negative 1.2 pmol/L or greater: Positive |
Laboratory Developed Test (LDT)
Note
If NMDA CSF antibody IgG is positive, then a NMDA CSF antibody IgG titer will be added. Additional charges apply.
If AQP4 CSF antibody IgG is positive, then an AQP4 CSF antibody IgG titer will be added. Additional charges apply.
If AMPA CSF antibody IgG is positive, then an AMPA CSF antibody IgG titer will be added. Additional charges apply.
If GABA-BR CSF antibody IgG is positive, then a GABA-BR CSF antibody IgG titer will be added. Additional charges apply.
If CASPR2 CSF antibody IgG is positive, then CASPR2 CSF antibody IgG titer will be added. Additional charges apply.
If LGI1 CSF antibody IgG is positive, then LGI1 CSF antibody IgG titer will be added. Additional charges apply.
If DPPX CSF antibody IgG is positive, then DPPX CSF antibody IgG titer will be added. Additional charges apply.
Hotline History
Hotline History
CPT Codes
86052; 86255 x6; 83519; 86341; if reflexed, add 86256 per titer.
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 |
| 3004513 | DPPX Ab IgG CBA IFA Screen, CSF | 94283-9 |
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