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Pediatric Autoimmune Encephalopathy/CNS Disorder Evaluation, Serum

Additional Codes

LAB2283


Ordering Guidance


Multiple neurological phenotype-specific autoimmune/paraneoplastic evaluations are available. For more information as well as phenotype-specific testing options, see Autoimmune Neurology Test Ordering Guide.

 

When more than one evaluation is ordered on the same order number, the duplicate test will be canceled.

 

For a list of antibodies performed with each evaluation, see Autoimmune Neurology Antibody Matrix.

 

This test should not be requested for patients who have recently received radioisotopes, therapeutically or diagnostically, because of potential assay interference. The specific waiting period before specimen collection will depend on the isotope administered, the dose given, and the clearance rate in the individual patient. Specimens will be screened for radioactivity prior to analysis. Radioactive specimens received in the laboratory will be held 1 week and assayed if sufficiently decayed or canceled if radioactivity remains.



Necessary Information


Provide the following information:

-Relevant clinical information

-Ordering healthcare professional's name, phone number, mailing address, and email address



Specimen Required


Patient Preparation: For optimal antibody detection, specimen collection is recommended prior to initiation of immunosuppressant medication or intravenous immunoglobulin treatment.

Supplies: Sarstedt Aliquot Tube, 5 mL (T914)

Collection Container/Tube:

Preferred: Red top

Acceptable: Serum gel

Submission Container/Tube: Plastic vial

Specimen Volume: 4 mL Serum

Collection Instructions: Centrifuge and aliquot serum into a plastic vial.


Profile Information

Test ID Reporting Name Available Separately Always Performed
PCSI Peds Autoimmune CNS Interp, S No Yes
AMPCS AMPA-R Ab CBA, S No Yes
ANN1S Anti-Neuronal Nuclear Ab, Type 1 No Yes
CS2CS CASPR2-IgG CBA, S No Yes
DPPCS DPPX Ab CBA, S No Yes
GBACS GABA-A-R Ab CBA, S Yes Yes
GABCS GABA-B-R Ab CBA, S No Yes
GD65S GAD65 Ab Assay, S Yes Yes
LG1CS LGI1-IgG CBA, S No Yes
GL1IS mGluR1 Ab IFA, S No Yes
GL5IS mGluR5 Ab IFA, S No Yes
MOGFS MOG FACS, S Yes Yes
NCDIS Neurochondrin IFA, S No Yes
NMDCS NMDA-R Ab CBA, S No Yes
NMOFS NMO/AQP4 FACS, S Yes Yes
PCATR Purkinje Cell Cytoplasmic Ab Type Tr No Yes

Reflex Tests

Test ID Reporting Name Available Separately Always Performed
AN1BS ANNA-1 Immunoblot, S No No
AN2BS ANNA-2 Immunoblot, S No No
DPPTS DPPX Ab IFA Titer, S No No
GL1CS mGluR1 Ab CBA, S No No
GL1TS mGluR1 Ab IFA Titer, S No No
MOGTS MOG FACS Titer, S No No
NMDIS NMDA-R Ab IF Titer Assay, S No No
NMOTS NMO/AQP4 FACS Titer, S No No
PCTBS PCA-Tr Immunoblot, S No No
AN1TS ANNA-1 Titer, S No No
GABIS GABA-B-R Ab IF Titer Assay, S No No
NCDCS Neurochondrin CBA, S No No
NCDTS Neurochondrin IFA Titer, S No No
PCTTS PCA-Tr Titer, S No No
AMPIS AMPA-R Ab IF Titer Assay, S No No
GL5CS mGluR5 Ab CBA, S No No
GL5TS mGluR5 Ab IFA Titer, S No No

Specimen Type

Serum

Specimen Minimum Volume

Serum: 2 mL

Specimen Stability Information

Specimen Type Temperature Time
Serum Refrigerated (preferred) 28 days
  Frozen  28 days
  Ambient  72 hours

Reference Values

Test ID

Reporting name

Methodology*

Reference value

PCSI

Peds Autoimmune CNS Interp, S

Technical interpretation

Interpretive report

AMPCS

AMPA-R Ab CBA, S

CBA

Negative

ANN1S

Anti-Neuronal Nuclear Ab, Type 1

IFA

Negative

CS2CS

CASPR2-IgG CBA, S

CBA

Negative

DPPCS

DPPX Ab CBA, S

CBA

Negative

GBACS

GABA-A-R Ab CBA, S

CBA

Negative

GABCS

GABA-B-R Ab CBA, S

CBA

Negative

GD65S

GAD65 Ab Assay, S

RIA

≤0.02 nmol/L

LG1CS

LGI1-IgG CBA, S

CBA

Negative

GL1IS

mGluR1 Ab IFA, S

IFA

Negative

GL5IS

mGluR5 Ab IFA, S

IFA

Negative

MOGFS

MOG FACS, S

FCM

Negative

NCDIS

Neurochondrin IFA, S

IFA

Negative

NMDCS

NMDA-R Ab CBA, S

CBA

Negative

NMOFS

NMO/AQP4 FACS, S

FCM

Negative

PCATR

Purkinje Cell Cytoplasmic Ab Type Tr

IFA

Negative

Reflex Information:

Test ID

Reporting name

Methodology

Reference value

AMPIS

AMPA-R Ab IF Titer Assay, S

IFA

<1:240

AN1BS

ANNA-1 Immunoblot, S

IB

Negative

AN1TS

ANNA-1 Titer, S

IFA

<1:240

AN2BS

ANNA-2 Immunoblot, S

IB

Negative

DPPTS

DPPX Ab IFA Titer, S

IFA

<1:240

GABIS

GABA-B-R Ab IF Titer Assay, S

IFA

<1:240

GL1CS

mGluR1 Ab CBA, S

CBA

Negative

GL1TS

mGluR1 Ab IFA Titer, S

IFA

<1:240

GL5CS

mGluR5 Ab CBA, S

CBA

Negative

GL5TS

mGluR5 Ab IFA Titer, S

IFA

<1:240

MOGTS

MOG FACS Titer, S

FCM

Negative

NCDCS

Neurochondrin CBA, S

CBA

Negative

NCDTS

Neurochondrin IFA Titer, S

IFA

<1:240

NMDIS

NMDA-R Ab IF Titer Assay, S

IFA

<1:240

NMOTS

NMO/AQP4 FACS Titer, S

FCM

Negative

PCTBS

PCA-Tr Immunoblot, S

IB

Negative

PCTTS

PCA-Tr Titer, S

IFA

<1:240

 

*Methodology abbreviations:

Cell-binding assay (CBA)

Flow Cytometry (FCM)

Immunoblot (IB)

Immunofluorescence assay (IFA)

Radioimmunoassay (RIA)

Day(s) Performed

Profile tests: Monday through Sunday; Reflex tests: Varies

Report Available

8 to 12 days

Specimen Retention Time

2 days

Performing Laboratory

Mayo Clinic Laboratories in Rochester

CPT Code Information

86341

86363

86053

86255 x 12

86256 AMPIS (if appropriate)

84182 AN1BS (if appropriate)

86256 AN1TS (if appropriate)

84182 AN2BS (if appropriate)

86256 DPPTS (if appropriate)

86256 GABIS (if appropriate)

86255 GL1CS (if appropriate)

86256 GL1TS (if appropriate)

86255 GL5CS (if appropriate)

86256 GL5TS (if appropriate)

86363 MOGTS (if appropriate)

86255 NCDCS (if appropriate)

86256 NCDTS (if appropriate)

86256 NMDIS (if appropriate)

86053 NMOTS (if appropriate)

84182 PCTBS (if appropriate)

86256 PCTTS (if appropriate)

LOINC Code Information

Test ID Test Order Name Order LOINC Value
PCDES Peds Autoimm Enceph CNS, S 101417-4

 

Result ID Test Result Name Result LOINC Value
61516 NMDA-R Ab CBA, S 93503-1
61518 AMPA-R Ab CBA, S 93489-3
61519 GABA-B-R Ab CBA, S 93428-1
620232 GABA-A-R Ab CBA, S 101874-6
623395 mGluR5 Ab IFA, S In Process
80150 ANNA-1, S 33615-6
81596 GAD65 Ab Assay, S 94345-6
83076 PCA-Tr, S 84926-5
615867 Neurochondrin IFA, S 101452-1
38324 NMO/AQP4 FACS, S 43638-6
64279 LGI1-IgG CBA, S 94287-0
64281 CASPR2-IgG CBA, S 94285-4
65563 MOG FACS, S 90248-6
64933 DPPX Ab CBA, S 94676-4
64928 mGluR1 Ab IFA, S 94347-2
605131 Peds Autoimmune CNS Interp, S 69048-7
618907 IFA Notes 48767-8