Ordering Recommendation

Use to evaluate new acute- to subacute-onset encephalopathy, dementia, or cognitive impairment. If new-onset epilepsy is the prominent feature, refer to Autoimmune Epilepsy Panel, Serum (3006203). If new-onset movement disorder is the prominent feature, refer to Autoimmune Movement Disorder Panel, Serum (3006206). For testing in individuals <18 years of age, refer to Autoimmune Pediatric CNS Disorders, Serum (3006210).

Testing in both serum and CSF is recommended to maximize diagnostic yield; refer to Autoimmune Encephalopathy/Dementia Panel, CSF (3006202) for CSF testing.

New York DOH Approval Status

This test is New York state approved.

Specimen Required

Patient Preparation

N/A

Collect

Serum sparator 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)

Methodology

Semi-Quantitative Cell-Based Indirect Fluorescent Antibody/Semi-Quantitative Indirect Fluorescent Antibody (IFA)/Qualitative Immunoblot/Semi-Quantitative Enzyme-Linked Immunosorbent Assay (ELISA)

Performed

Varies

Reported

3-10 days

Reference Interval

Test Number
Components
Reference Interval
  CV2 Ab IgG CBA-IFA Screen, Serum Less than 1:100
  Neuronal Antibody (Amphiphysin) Negative
  Glutamic Acid Decarboxylase Antibody 0.0-5.0 IU/mL
  Purkinje Cell/Neuronal Nuclear IgG Scrn None Detected
  NMDA Receptor Ab IgG CBA-IFA, Serum Less than 1:10
  SOX1 Antibody, IgG by Immunoblot, Serum Negative
  AMPA Receptor Ab IgG CBA-IFA Scrn, Serum Less than 1:10
  GABA-BR Ab IgG CBA-IFA Scrn, Ser Less than 1:10
  DPPX Ab IgG CBA-IFA Screen, Serum Less than 1:10
  IgLON5 Ab IgG CBA-IFA Screen, Serum Less than 1:10
  mGluR1 Ab IgG CBA-IFA Screen, Serum Less than 1:10
  CASPR2 Ab IgG CBA-IFA Screen, Serum Less than 1:10
  LGI1 Ab IgG CBA-IFA Screen, Serum Less than 1:10

Interpretive Data

Refer to report

Compliance Category

Laboratory Developed Test (LDT)

Note

If NMDA antibody IgG is positive, then titer will be performed. Additional charges apply.
If CV2 antibody IgG is positive, then titer will be added. Additional charges apply.
PCCA/ANNA antibody IgG is 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 LGI1 antibody IgG is positive, then titer will be added. Additional charges apply.
If CASPR2 antibody IgG is positive, then titer will be added. Additional charges apply.
If AMPA antibody IgG is positive, then titer will be added. Additional charges apply.
If GABA-BR antibody IgG is positive, then titer will be added. Additional charges apply.
If DPPX antibody IgG by IFA is positive, then titer will be added. Additional charges apply.
If IgLON5 antibody IgG by IFA is positive, then titer will be added. Additional charges apply.
If mGluR1 antibody IgG by IFA is positive, then titer will be added. Additional charges apply.

Hotline History

N/A

CPT Codes

86341; 84182 x2; 86255 x10; if reflexed add 84182 x4; 86256 per titer

Components

Component Test Code* Component Chart Name LOINC
0051709 Neuronal Antibody (Amphiphysin) 94385-2
2001772 Glutamic Acid Decarboxylase Antibody 56540-8
2004222 NMDA Receptor Ab IgG CBA-IFA, Serum 80221-5
2007962 Purkinje Cell/Neuronal Nuclear IgG Scrn 61177-2
2009453 CASPR2 Ab IgG CBA-IFA Screen, Serum 82979-6
2009457 LGI1 Ab IgG CBA-IFA Screen, Serum 82978-8
2013959 CV2 Ab IgG CBA-IFA Screen, Serum 72504-4
3001261 AMPA Receptor Ab IgG CBA-IFA Scrn, Serum 82733-7
3001271 GABA-BR Ab IgG CBA-IFA Scrn, Ser 93428-1
3002903 SOX1 Antibody, IgG by Immunoblot, Serum 82444-1
3004361 DPPX Ab IgG CBA-IFA Screen, Serum 94676-4
3006019 IgLON5 Ab IgG CBA-IFA Screen, Serum 96478-3
3006045 mGluR1 Ab IgG CBA-IFA Screen, Serum 93498-4
* 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

  • AGNA
  • AMPA
  • AMPA-R
  • Amphiphysin
  • ANNA
  • Anti-glial nuclear antibody
  • Anti-neuronal nuclear antibody
  • CASPR2
  • Cognitive decline
  • Cognitive impairment
  • Contactin-associated protein-like-2
  • CRMP-5
  • CV2
  • Dementia
  • Dipeptidyl aminopeptidase-like protein 6
  • DPPX
  • encephalitis
  • encephalopathy
  • GABA-B
  • GABA-BR
  • GAD65
  • Glutamic acid decarboxylase
  • Hu
  • IgLON5
  • Leucine-rich glioma inactivated protein-1
  • LGI1
  • metabotropic glutamate receptor 1
  • mGluR1
  • NMDA
  • NMDA-R
  • PCA
  • PCCA
  • Purkinje cell cytoplasmic antibody
  • Ri
  • Yo
Autoimmune Encephalopathy/Dementia Panel, Serum