Ordering Recommendation

Use to evaluate subacute-onset encephalopathy, epilepsy, behavior changes, or movement disorders in individuals <18 years of age.

Testing in both serum and CSF is recommended to maximize diagnostic yield; refer to Autoimmune Pediatric CNS Disorders, CSF (3006211) for CSF testing.

New York DOH Approval Status

This test is New York state approved.

Specimen Required

Patient Preparation

N/A

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)

Methodology

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

Performed

Varies

Reported

3-10 days

Reference Interval

Test Number
Components
Reference Interval
  Purkinje Cell/Neuronal Nuclear IgG Scrn None Detected
  Glutamic Acid Decarboxylase Antibody 0.0-5.0 IU/mL
  NMDA Receptor Ab IgG CBA-IFA, Serum Less than 1:10
  NMO/AQP4 Ab IgG CBA-IFA Screen, Serum Less than 1:10
  GABA-BR Ab IgG CBA-IFA Scrn, Ser Less than 1:10
  MOG Ab IgG CBA-IFA Screen, Serum Less than 1:10
  DPPX Ab IgG CBA-IFA Screen, Serum Less than 1:10
  GABA-AR 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.

PCCA/ANNA antibody IgG is screened by IFA. If the IFA screen is indeterminate, then a Neuronal Nuclear Antibodies (Hu 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 and 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 AQP4/NMO antibody IgG by IFA is positive, then titer will be added. Additional charges apply.

If GABA-BR antibody IgG by IFA is positive, then titer will be added. Additional charges apply.


If MOG antibody IgG by IFA 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 mGluR1 antibody IgG by IFA is positive, then titer will be added. Additional charges apply.

If GABA-AR antibody IgG by IFA is positive, then titer will be added. Additional charges apply

Hotline History

N/A

CPT Codes

86341; 86362; 86052; 86255 x8; if reflexed add 84182 x2; 86256 per titer

Components

Component Test Code* Component Chart Name LOINC
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
2013322 NMO/AQP4 Ab IgG CBA-IFA Screen, Serum 63439-4
3001271 GABA-BR Ab IgG CBA-IFA Scrn, Ser 93428-1
3001278 MOG Ab IgG CBA-IFA Screen, Serum 91545-4
3004361 DPPX Ab IgG CBA-IFA Screen, Serum 94676-4
3006009 GABA-AR Ab IgG CBA-IFA Screen, Serum
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

  • Acute disseminated encephalomyelitis
  • ADEM
  • ANNA
  • Anti-neuronal nuclear antibody
  • AQP4
  • Aquaporin 4
  • CASPR2
  • Child
  • Contactin-associated protein-like-2
  • Dipeptidyl aminopeptidase-like protein 6
  • DPPX
  • Encephalitis, Encephalopathy
  • epilepsy
  • GABA-A
  • GABA-AR
  • GABA-B
  • GABA-BR
  • GAD65
  • Glutamic acid decarboxylase
  • Leucine-rich glioma inactivated protein-1
  • LGI1
  • metabotropic glutamate receptor 1
  • mGluR1
  • MOG
  • Myelin oligodendrocyte glycoprotein
  • Myelitis
  • Myelopathy
  • NMDA
  • NMDA-R
Autoimmune Pediatric CNS Disorders, Serum