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 R3

Methodology

Semi-Quantitative Cell-Based 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: 30 days (avoid repeated freeze/thaw cycles)

Reference Interval

Test Number
Components
Reference Interval
  Neuronal Antibody (Amphiphysin) Negative
  P/Q-Type Calcium Channel Antibody 24.5 pmol/L or less
  Glutamic Acid Decarboxylase Antibody 0.0-5.0 IU/mL
  N-methyl-D-Aspartate Receptor Ab, Serum Less than 1:10
  Voltage-Gated Potassium Channel Ab, Ser 31 pmol/L or less
  Purkinje Cell/Neuronal Nuclear IgG Scrn None Detected
  CASPR2 Ab IgG Screen by IFA, Serum Less than 1:10
  LGI1 Ab IgG Screen by IFA, Serum Less than 1:10
  Neuromyelitis Optica/AQP4-IgG, Serum Less than 1:10
  CV2.1 Antibody IgG Screen by IFA Less than 1:10
  AMPA Receptor Ab IgG Screen, Serum Less than 1:10
  GABA-B Receptor Ab IgG Screen, Serum Less than 1:10
  MOG Antibody IgG Screen, Serum Less than 1:10
  SOX1 Antibody, IgG by Immunoblot, Serum Negative
  Ganglionic Acetylcholine Receptor Ab 8.4 pmol/L or less
  DPPX Ab IgG CBA IFA Screen, Serum Less than 1:10

Interpretive Data

Refer to Report

This test was developed and its performance characteristics determined by ARUP Laboratories. It has not been cleared or approved by the US Food and Drug Administration. This test was performed in a CLIA certified laboratory and is intended for clinical purposes.


Component
Interpretation
Voltage-Gated Potassium Channel (VGKC) Antibody, Serum 31 pmol/L or less  Negative
32-87 pmol/L  Indeterminate
88 pmol/L or greater  Positive
P/Q-Type Voltage-Gated Calcium Channel (VGCC) Antibody 0.0 to 24.5 pmol/L  Negative
24.6 to 45.6 pmol/L  Indeterminate
45.7 pmol/L or greater  Positive
Ganglionic Acetylcholine Receptor Antibody 0.0 - 8.4 pmol/L  Negative
8.5 - 11.6 pmol/L  Indeterminate
11.7 pmol/L or greater Positive

Compliance Category

Laboratory Developed Test (LDT)

Note

If N-methyl-D-Aspartate Receptor Antibody is positive, then titer will be performed. Additional charges apply.
If CV2.1 Antibody IgG Screen by IFA is positive, then titer will be performed and Acetylcholine Receptor Binding Antibody will be added. Additional charges apply.
If Aquaporin-4 Receptor Antibody, IgG by IFA with Reflex to Titer, Serum is positive, then titer will be performed. 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, Yo, and Tr/DNER) IgG by Immunoblot will be performed. If the IFA screen is positive at 1:10 or greater, then a PCCA/ANNA antibodies titer and Neuronal Nuclear Antibodies (Hu, Ri, Yo, Tr/DNER) IgG by Immunoblot will be performed. Additional charges apply.
If Leucine-Rich, Glioma-Inactivated Protein 1 Antibody, IgG with Reflex to Titer, Serum is positive, then Leucine-Rich, Glioma-Inactivated Protein 1 Antibody Titer, IgG by IFA, Serum will be performed. Additional charges apply.
If Contactin-Associated Protein-2 Antibody, IgG with Reflex to Titer, Serum is positive, then Contactin-Associated Protein-2 Antibody Titer, IgG by IFA, Serum will be performed. 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 will be performed. 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 will be 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 will be performed. Additional charges apply.
If Dipeptidyl aminopeptidase-like protein 6 (DPPX) antibody, IgG by IFA with reflex to Titer, Serum is positive, then a Dipeptidyl aminopeptidase-like protein 6 (DPPX) antibody Titer, IgG will be performed. Additional charges apply.

Hotline History

N/A

CPT Codes

83519 x2; 84182 x2; 86255 x8; 86341; 86052; 86362; 86596; if reflexed, add 83519; 84182 x4; 86256 x11

Components

Component Test Code* Component Chart Name LOINC
0051709 Neuronal Antibody (Amphiphysin) 94385-2
0092629 P/Q-Type Calcium Channel Antibody 33980-4
2001772 Glutamic Acid Decarboxylase Antibody 56540-8
2004222 N-methyl-D-Aspartate Receptor Ab, Serum 80221-5
2004890 Voltage-Gated Potassium Channel Ab, Ser 41871-5
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
2013322 Neuromyelitis Optica/AQP4-IgG, Serum 63439-4
2013959 CV2.1 Antibody IgG Screen by IFA 72504-4
3001261 AMPA Receptor Ab IgG Screen, Serum 82733-7
3001271 GABA-B Receptor Ab IgG Screen, Serum 93428-1
3001278 MOG Antibody IgG Screen, Serum 91545-4
3002903 SOX1 Antibody, IgG by Immunoblot, Serum 82444-1
3003019 Ganglionic Acetylcholine Receptor Ab 42233-7
3004361 DPPX Ab IgG CBA IFA Screen, Serum 94676-4
* 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.

Aliases

  • Dementia antibody panel
  • Encephalitis antibody panel
  • Epilepsy antibody panel
  • Movement Disorders antibody panel
  • Myelopathy antibody panel
  • Paraneoplastic antibody panel
Autoimmune Neurologic Disease Reflexive Panel, Serum