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, Serum (3006210) for serum testing.

New York DOH Approval Status

This test is New York state approved.

Specimen Required

Patient Preparation

N/A

Collect

CSF

Specimen Preparation

Transfer three 1 mL CSF aliquots to ARUP standard transport tubes. (Min: 0.5 mL/aliquot)

Storage/Transport Temperature

Frozen

Unacceptable Conditions

Fluid other than CSF. Grossly hemolyzed 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
  mGluR1 Ab IgG CBA-IFA Screen, CSF Less than 1:1
  Glutamic Acid Decarboxylase Antibody CSF 0.0-5.0 IU/mL
  LGI1 Ab IgG CBA-IFA Screen, CSF Less than 1:1
  NMDA Receptor Ab IgG CBA-IFA, CSF Less than 1:1
  NMO/AQP4 Ab IgG CBA-IFA Screen, CSF Less than 1:1
  CASPR2 Ab IgG CBA-IFA Screen, CSF Less than 1:1
  GABA-BR Ab IgG CBA-IFA Screen, CSF Less than 1:1
  DPPX Ab IgG CBA-IFA Screen, CSF Less than 1:1
  GABA-AR Ab IgG CBA-IFA Screen, CSF Less than 1:1
  Paraneoplastic Abs (PCCA/ANNA) IgG, CSF None Detected

Interpretive Data

Refer to report.

Compliance Category

Laboratory Developed Test (LDT)

Note

If NMDA CSF 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 CSF antibody IgG is positive, then titer will be added. Additional charges apply.

If CASPR2 CSF antibody IgG is positive, then titer will be added. Additional charges apply.

If AQP4/NMO CSF antibody IgG by IFA is positive, then titer will be added. Additional charges apply.

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

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

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

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

Hotline History

N/A

CPT Codes

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

Components

Component Test Code* Component Chart Name LOINC
2005165 NMDA Receptor Ab IgG CBA-IFA, CSF 80220-7
2010842 Paraneoplastic Abs (PCCA/ANNA) IgG, CSF 14247-1
2011700 NMO/AQP4 Ab IgG CBA-IFA Screen, CSF 46718-3
3001268 GABA-BR Ab IgG CBA-IFA Screen, CSF 82984-6
3001987 CASPR2 Ab IgG CBA-IFA Screen, CSF 90820-2
3001991 LGI1 Ab IgG CBA-IFA Screen, CSF 90830-1
3002789 Glutamic Acid Decarboxylase Antibody CSF 42501-7
3004513 DPPX Ab IgG CBA-IFA Screen, CSF 94283-9
3006004 GABA-AR Ab IgG CBA-IFA Screen, CSF
3006040 mGluR1 Ab IgG CBA-IFA Screen, CSF 93500-7
* 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

  • 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
  • Myelitis
  • Myelopathy
  • NMDA
  • NMDA-R
Autoimmune Pediatric CNS Disorders, CSF