Test Code LAB93743 Dementia, Autoimmune/Paraneoplastic Evaluation, Serum
Additional Codes
Mayo test code: DMS2
Ordering Guidance
Multiple neurological phenotype-specific autoimmune/paraneoplastic evaluations are available. For more information as well as phenotype-specific testing options, refer to 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 provider name, phone number, mailing address, and e-mail address
Specimen Required
Patient Preparation:
1. For optimal antibody detection, specimen collection is recommended before initiation of immunosuppressant medication or intravenous immunoglobulin treatment.
2. For 24 hours before specimen collection, patient should not receive general anesthetic or take muscle-relaxant drugs.
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
Collection Instructions: Centrifuge and aliquot serum into a plastic vial.
Forms
If not ordering electronically, complete, print, and send a Neurology Specialty Testing Client Test Request (T732) with the specimen.
Useful For
Investigating new onset dementia and cognitive impairment plus 1 or more of the following using serum specimens:
-Rapid onset and progression
-Fluctuating course
-Psychiatric accompaniments (psychosis, hallucinations)
-Movement disorder (myoclonus, tremor, dyskinesias)
-Headache
-Autoimmune stigmata (personal history or family history or signs of diabetes mellitus, thyroid disorder, vitiligo, poliosis [premature graying], myasthenia gravis, rheumatoid arthritis, systemic lupus erythematosus)
-Smoking history (over 20 pack-years) or other cancer risk factors
-History of cancer
-Inflammatory cerebrospinal fluid
-Neuroimaging findings atypical for degenerative etiology
Profile Information
Test ID | Reporting Name | Available Separately | Always Performed |
---|---|---|---|
ADMSI | Dementia, Interpretation, S | No | Yes |
AMPCS | AMPA-R Ab CBA, S | No | Yes |
AMPHS | Amphiphysin Ab, S | No | Yes |
AGN1S | Anti-Glial Nuclear Ab, Type 1 | No | Yes |
ANN1S | Anti-Neuronal Nuclear Ab, Type 1 | No | Yes |
ANN2S | Anti-Neuronal Nuclear Ab, Type 2 | No | Yes |
ANN3S | Anti-Neuronal Nuclear Ab, Type 3 | No | Yes |
CS2CS | CASPR2-IgG CBA, S | No | Yes |
CRMS | CRMP-5-IgG, S | No | Yes |
DPPCS | DPPX Ab CBA, S | No | Yes |
GABCS | GABA-B-R Ab CBA, S | No | Yes |
GD65S | GAD65 Ab Assay, S | Yes | Yes |
GFAIS | GFAP IFA, S | No | Yes |
IG5CS | IgLON5 CBA, S | No | Yes |
LG1CS | LGI1-IgG CBA, S | No | Yes |
GL1IS | mGluR1 Ab IFA, S | No | Yes |
NCDIS | Neurochondrin IFA, S | No | Yes |
NIFIS | NIF IFA, S | No | Yes |
NMDCS | NMDA-R Ab CBA, S | No | Yes |
PCAB2 | Purkinje Cell Cytoplasmic Ab Type 2 | No | Yes |
PCATR | Purkinje Cell Cytoplasmic Ab Type Tr | No | Yes |
PDEIS | PDE10A Ab IFA, S | No | Yes |
T46IS | TRIM46 Ab IFA, S | No | Yes |
Reflex Tests
Test ID | Reporting Name | Available Separately | Always Performed |
---|---|---|---|
AGNBS | AGNA-1 Immunoblot, S | No | No |
AINCS | Alpha Internexin CBA, S | No | No |
AMPIS | AMPA-R Ab IF Titer Assay, S | No | No |
AMIBS | Amphiphysin Immunoblot, S | No | No |
AN1BS | ANNA-1 Immunoblot, S | No | No |
AN2BS | ANNA-2 Immunoblot, S | No | No |
CRMWS | CRMP-5-IgG Western Blot, S | Yes | No |
DPPTS | DPPX Ab IFA Titer, S | No | No |
GABIS | GABA-B-R Ab IF Titer Assay, S | No | No |
GFACS | GFAP CBA, S | No | No |
GFATS | GFAP IFA Titer, S | No | No |
IG5TS | IgLON5 IFA Titer, S | No | No |
GL1CS | mGluR1 Ab CBA, S | No | No |
GL1TS | mGluR1 Ab IFA Titer, S | No | No |
NFHCS | NIF Heavy Chain CBA, S | No | No |
NIFTS | NIF IFA Titer, S | No | No |
NFLCS | NIF Light Chain CBA, S | No | No |
NMDIS | NMDA-R Ab IF Titer Assay, S | No | No |
PCTBS | PCA-Tr Immunoblot, S | No | No |
AN1TS | ANNA-1 Titer, S | No | No |
AN2TS | ANNA-2 Titer, S | No | No |
AN3TS | ANNA-3 Titer, S | No | No |
APHTS | Amphiphysin Ab Titer, S | No | No |
CRMTS | CRMP-5-IgG Titer, S | No | No |
NCDCS | Neurochondrin CBA, S | No | No |
NCDTS | Neurochondrin IFA Titer, S | No | No |
PC2TS | PCA-2 Titer, S | No | No |
PCTTS | PCA-Tr Titer, S | No | No |
AGNTS | AGNA-1 Titer, S | No | No |
PDETS | PDE10A Ab IFA Titer, S | No | No |
T46CS | TRIM46 Ab CBA, S | No | No |
T46TS | TRIM46 Ab IFA Titer, S | No | No |
Testing Algorithm
To determine the necessity of laboratory testing for patients with suspected autoimmune encephalitis, epilepsy or dementia, see the Antibody Prevalence in Epilepsy and Encephalopathy (APE2) scorecard.
If the indirect immunofluorescence assay (IFA) pattern suggests antiglial nuclear antibody (AGNA)-1, then the AGNA-1 immunoblot and AGNA-1 IFA titer will be performed at an additional charge.
If the IFA pattern suggests antineuronal nuclear antibody type 1 (ANNA-1), then the ANNA-1 immunoblot, ANNA-1 IFA titer, and ANNA-2 immunoblot will be performed at an additional charge.
If the IFA pattern suggests ANNA-2 antibody, then the ANNA-2 immunoblot, ANNA-2 IFA titer, and ANNA-1 immunoblot will be performed at an additional charge.
If client requests or if the IFA pattern suggests ANNA-3 antibody, then the ANNA-3 IFA titer will be performed at an additional charge.
If the IFA pattern suggests amphiphysin antibody, then the amphiphysin immunoblot and amphiphysin IFA titer will be performed at an additional charge.
If client requests or if the IFA patterns suggest collapsin response-mediator protein 5 (CRMP-5)-IgG, then the CRMP-5-IgG Western blot and CRMP-5-IgG IFA titer will be performed at an additional charge.
If the AMPA (alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid 9) receptor antibody cell-binding assay (CBA) result is positive, then the AMPA receptor antibody IFA titer will be performed at an additional charge.
If the contactin-associated protein-like-2 (CASPR2)-receptor antibody CBA result is positive, then the CRMP-5-IgG Western blot will be performed at an additional charge.
If the gamma-aminobutyric acid B (GABA-B) receptor antibody CBA result is positive, then the GABA-B receptor antibody IF titer will be performed at an additional charge.
If IFA pattern suggests glial fibrillary acidic protein (GFAP) antibody, then the GFAP IFA titer and GFAP CBA will be performed at an additional charge.
If the N-methyl-D-aspartate (NMDA)-receptor antibody CBA is positive, then NMDA receptor antibody IF titer will be performed at an additional charge.
If the IFA pattern suggests PCA-Tr antibody, then the PCA-Tr immunoblot and PCA-Tr IFA titer will be performed at an additional charge.
If dipeptidyl-peptidase-like protein-6 (DPPX) antibody CBA result is positive, then the DPPX IFA titer will be performed at an additional charge.
If the IFA pattern suggests metabotropic glutamate receptor 1 (mGluR1) antibody, then the mGluR1 antibody CBA and mGluR1 IFA titer will be performed at an additional charge.
If the IgLON5 antibody CBA result is positive, then the IgLON5 IFA titer will be performed at an additional charge.
If the IFA pattern suggests neuronal intermediate filament (NIF) antibody, then the alpha internexin CBA, NIF heavy chain CBA, NIF light chain CBA, and NIF IFA titer will be performed at an additional charge.
If the IFA pattern suggests neurochondrin antibody, then the neurochondrin antibody CBA and neurochondrin IFA titer will be performed at an additional charge.
If the IFA pattern suggests tripartite motif-containing protein 46 (TRIM46) antibody, then the TRIM46 antibody CBA and TRIM46 IFA titer will be performed at an additional charge.
If the IFA pattern suggests phosphodiesterase 10A (PDE10A) antibody, then the PDE10A antibody IFA titer will be performed at an additional charge.
For more information see Autoimmune/Paraneoplastic Dementia Evaluation Algorithm-Serum.
Special Instructions
Method Name
AMPCS, CS2CS, LG1CS, DPPCS, GABCS, GFACS, IG5CS, GL1CS, NCDCS, AINCS, NFLCS, NFHCS, NMDCS, T46CS: Cell Binding Assay (CBA)
AGN1S, AGNTS, AMPIS, AMPHS, APHTS, ANN1S, AN1TS, ANN2S, AN2TS, ANN3S, AN3TS, CRMS, CRMTS, DPPTS, GABIS, GFAIS, GFATS, IG5TS, GL1IS, GL1TS, NCDIS, NCDTS, NIFIS, NIFTS, NMDIS, PCAB2, PC2TS, PCATR, PCTTS, PDEIS, PDETS, T46IS, T46TS: Indirect Immunofluorescence Assay (IFA)
GD65S: Radioimmunoassay (RIA)
CRMWS: Western Blot (WB)
AGNBS, AMIBS, AN1BS, AN2BS, PCTBS: Immunoblot (IB)
Reporting Name
Dementia, Autoimm/Paraneo, SSpecimen Type
SerumSpecimen Minimum Volume
2.5 mL
Specimen Stability Information
Specimen Type | Temperature | Time | Special Container |
---|---|---|---|
Serum | Refrigerated (preferred) | 28 days | |
Frozen | 28 days | ||
Ambient | 72 hours |
Reference Values
Test ID |
Reporting name |
Methodology |
Reference value |
ADMSI |
Dementia, Interpretation, S |
Medical interpretation |
Interpretive report |
AMPCS |
AMPA-R Ab CBA, S |
CBA |
Negative |
AMPHS |
Amphiphysin Ab, S |
IFA |
<1:240 |
AGN1S |
Anti-Glial Nuclear Ab, Type 1 |
IFA |
<1:240 |
ANN1S |
Anti-Neuronal Nuclear Ab, Type 1 |
IFA |
<1:240 |
ANN2S |
Anti-Neuronal Nuclear Ab, Type 2 |
IFA |
<1:240 |
ANN3S |
Anti-Neuronal Nuclear Ab, Type 3 |
IFA |
<1:240 |
CS2CS |
CASPR2-IgG CBA, S |
CBA |
Negative |
CRMS |
CRMP-5-IgG, S |
IFA |
<1:240 |
DPPCS |
DPPX Ab CBA, S |
CBA |
Negative |
GABCS |
GABA-B-R Ab CBA, S |
CBA |
Negative |
GD65S |
GAD65 Ab Assay, S |
RIA |
≤0.02 nmol/L Reference values apply to all ages. |
GFAIS |
GFAP IFA, S |
IFA |
Negative |
IG5CS |
IgLON5 CBA, S |
CBA |
Negative |
LG1CS |
LGI1-IgG CBA, S |
CBA |
Negative |
GL1IS |
mGluR1 Ab IFA, S |
IFA |
Negative |
NCDIS |
Neurochondrin IFA, S |
IFA |
Negative |
NIFIS |
NIF IFA, S |
IFA |
Negative |
NMDCS |
NMDA-R Ab CBA, S |
CBA |
Negative |
PCAB2 |
Purkinje Cell Cytoplasmic Ab Type 2 |
IFA |
<1:240 |
PCATR |
Purkinje Cell Cytoplasmic Ab Type Tr |
IFA |
<1:240 |
PDEIS |
PDE10A Ab IFA, S |
IFA |
Negative |
T46IS |
TRIM46 IFA, S |
IFA |
Negative |
Reflex Information:
Test ID |
Reporting name |
Methodology |
Reference value |
AGNBS |
AGNA-1 Immunoblot, S |
IB |
Negative |
AGNTS |
AGNA-1 Titer, S |
IFA |
<1:240 |
AINCS |
Alpha Internexin CBA, S |
CBA |
Negative |
AMPIS |
AMPA-R Ab IF Titer Assay, S |
IFA |
<1:240 |
AMIBS |
Amphiphysin Immunoblot, S |
IB |
Negative |
AN1BS |
ANNA-1 Immunoblot, S |
IB |
Negative |
AN1TS |
ANNA-1 Titer, S |
IFA |
<1:240 |
AN2BS |
ANNA-2 Immunoblot, S |
IB |
Negative |
AN2TS |
ANNA-2 Titer, S |
IFA |
<1:240 |
AN3TS |
ANNA-3 Titer, S |
IFA |
<1:240 |
APHTS |
Amphiphysin Ab Titer, S |
IFA |
<1:240 |
CRMTS |
CRMP-5-IgG Titer, S |
IFA |
<1:240 |
CRMWS |
CRMP-5-IgG Western Blot, S |
WB |
Negative |
DPPTS |
DPPX Ab IFA Titer, S |
IFA |
<1:240 |
GABIS |
GABA-B-R Ab IF Titer Assay, S |
IFA |
<1:240 |
GFACS |
GFAP CBA, S |
CBA |
Negative |
GFATS |
GFAP IFA Titer, S |
IFA |
<1:240 |
IG5TS |
IgLON5 IFA Titer, S |
IFA |
<1:240 |
GL1CS |
mGluR1 Ab CBA, S |
CBA |
Negative |
GL1TS |
mGluR1 Ab IFA Titer, S |
IFA |
<1:240 |
NCDCS |
Neurochondrin CBA, S |
CBA |
Negative |
NCDTS |
Neurochondrin IFA Titer, S |
IFA |
<1:240 |
NFHCS |
NIF Heavy Chain CBA, S |
CBA |
Negative |
NIFTS |
NIF IFA Titer, S |
IFA |
<1:240 |
NFLCS |
NIF Light Chain CBA, S |
CBA |
Negative |
NMDIS |
NMDA-R Ab IF Titer Assay, S |
IFA |
<1:240 |
PC2TS |
PCA-2 Titer, S |
IFA |
<1:240 |
PCTTS |
PCA-Tr Titer, S |
IFA |
<1:240 |
PCTBS |
PCA-Tr Immunoblot, S |
IB |
Negative |
PDETS |
PDE10A Ab IFA Titer, S |
IFA |
<1:240 |
T46CS |
TRIM46 CBA, S |
CBA |
Negative |
T46TS |
TRIM46 IFA Titer, S |
IFA |
<1:240 |
*Methodology abbreviations used:
Immunofluorescence assay (IFA)
Cell-binding assay (CBA)
Western blot (WB)
Radioimmunoassay (RIA)
Immunoblot (IB)
Neuron-restricted patterns of IgG staining that do not fulfill criteria for ANNA-1, ANNA-2, ANNA-3 CRMP-5-IgG, PCA-1, PCA-2, or PCA-Tr may be reported as "unclassified anti-neuronal IgG." Complex patterns that include nonneuronal elements may be reported as "uninterpretable."
Note: CRMP-5 titers lower than 1:240 are detectable by recombinant CRMP-5 Western blot analysis. CRMP-5 Western blot analysis will be done on request on stored serum (held 4 weeks). This supplemental testing is recommended in cases of chorea, vision loss, cranial neuropathy, and myelopathy. Call the Neuroimmunology Laboratory at 800-533-1710 to request CRMP-5 Western blot.
Day(s) Performed
Report Available
8 to 12 daysPerforming Laboratory
Mayo Clinic Laboratories in RochesterTest Classification
This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.CPT Code Information
86255 x 21
86341
84182-AGNBS (if appropriate)
86256 AGNTS (if appropriate)
86255-AINCS (if appropriate)
86256-AMPIS (if appropriate)
84182-AMIBS (if appropriate)
84182-AN1BS (if appropriate)
86256-AN1TS (if appropriate)
84182-AN2BS (if appropriate)
86256-AN2TS (if appropriate)
86256-AN3TS (if appropriate)
86256-APHTS (if appropriate)
86256-CRMTS (if appropriate)
84182-CRMWS (if appropriate)
86256-DPPTS (if appropriate)
86256-GABIS (if appropriate)
86255-GFACS (if appropriate)
86256-GFATS (if appropriate)
86256-IG5TS (if appropriate)
86255-GL1CS (if appropriate)
86256-GL1TS (if appropriate)
86255-NCDCS (if appropriate)
86256-NCDTS (if appropriate)
86255-NFHCS (if appropriate)
86256-NIFTS (if appropriate)
86255-NFLCS (if appropriate)
86256-NMDIS (if appropriate)
86256-PC2TS (if appropriate)
84182-PCTBS (if appropriate)
86256-PCTTS (if appropriate)
86256 PDETS (if appropriate)
86255 T46CS (if appropriate)
86256 T46TS (if appropriate)
LOINC Code Information
Test ID | Test Order Name | Order LOINC Value |
---|---|---|
DMS2 | Dementia, Autoimm/Paraneo, S | 94696-2 |
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 |
606950 | IgLON5 CBA, S | 96478-3 |
615867 | Neurochondrin IFA, S | 101452-1 |
616445 | TRIM46 Ab IFA, S | 103843-9 |
620068 | PDE10A Ab IFA, S | 103842-1 |
34255 | Dementia, Interpretation, S | 69048-7 |
64279 | LGI1-IgG CBA, S | 94287-0 |
64281 | CASPR2-IgG CBA, S | 94285-4 |
64933 | DPPX Ab CBA, S | 94676-4 |
64928 | mGluR1 Ab IFA, S | 94347-2 |
605155 | GFAP IFA, S | 94346-4 |
606964 | NIF IFA, S | 96486-6 |
89080 | AGNA-1, S | 84927-3 |
81722 | Amphiphysin Ab, S | 72327-0 |
80150 | ANNA-1, S | 33615-6 |
80776 | ANNA-2, S | 43187-4 |
83137 | ANNA-3, S | 43102-3 |
83077 | CRMP-5-IgG, S | 72504-4 |
81596 | GAD65 Ab Assay, S | 30347-9 |
83138 | PCA-2, S | 84925-7 |
83076 | PCA-Tr, S | 84926-5 |
618894 | IFA Notes | 48767-8 |