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Test Mnemonic DMS1 Dementia, Autoimmune Evaluation, Serum

Useful For

Investigating new onset dementia and cognitive impairment plus 1 or more of the following:

-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 (20+ pack years) or other cancer risk factors

-History of cancer

-Inflammatory cerebral spinal fluid

-Neuroimaging findings atypical for degenerative etiology

Profile Information

Test ID Reporting Name Available Separately Always Performed
ADMSI Dementia, Interpretation, S No Yes
NMDCS NMDA-R Ab CBA, S No Yes
VGKC Neuronal (V-G) K+ Channel Ab, S No Yes
LG1CS LGI1-IgG CBA, S No Yes
CS2CS CASPR2-IgG CBA, S No Yes
GD65S GAD65 Ab Assay, S Yes Yes
GABCS GABA-B-R Ab CBA, S No Yes
AMPCS AMPA-R Ab CBA, S 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
AGN1S Anti-Glial Nuclear Ab, Type 1 No Yes
PCAB2 Purkinje Cell Cytoplasmic Ab Type 2 No Yes
PCATR Purkinje Cell Cytoplasmic Ab Type Tr No Yes
AMPHS Amphiphysin Ab, S No Yes
CCN N-Type Calcium Channel Ab No Yes
CCPQ P/Q-Type Calcium Channel Ab No Yes
ARBI ACh Receptor (Muscle) Binding Ab No Yes
GANG AChR Ganglionic Neuronal Ab, S No Yes
CRMS CRMP-5-IgG, S No Yes

Reflex Tests

Test ID Reporting Name Available Separately Always Performed
WBN Paraneoplastic Autoantibody WBlot,S No No
CRMWS CRMP-5-IgG Western Blot, S Yes No
ABLOT Amphiphysin Western Blot, S No No
NMOFS NMO/AQP4 FACS, S Yes No
NMOTS NMO/AQP4 FACS Titer, S No No
AMPIS AMPA-R Ab IF Titer Assay, S No No
GABIS GABA-B-R Ab IF Titer Assay, S No No
NMDIS NMDA-R Ab IF Titer Assay, S No No
PCABP Purkinje Cell Cytoplasmic Ab Type 1 No No

Testing Algorithm

If indirect immunofluorescence assay (IFA) (ANNA-1, ANNA-2, ANNA-3, PCA-2, PCA-Tr, Amphiphysin, CRMP-5-IgG, AGNA-1)) is indeterminate, paraneoplastic autoantibody Western blot is performed at an additional charge.

 

If client requests or if IFA patterns suggest CRMP-5-IgG, CRMP-5-IgG Western blot is performed at an additional charge.

 

If IFA patterns suggest amphiphysin antibody, amphiphysin Western blot is performed at an additional charge.

 

If IFA pattern suggest NMO/AQP4-IgG, NMO/AQP4-IgG FACS is performed at an additional charge.

 

If NMO/AQP4-IgG FACS screen assay requires further investigation, then NMO/AQP4-IgG FACS titration assay is performed at an additional charge.

 

If IFA pattern suggest AMPA-Receptor antibody and AMPA-Receptor antibody CBA is positive, AMPA-Receptor antibody IF titer assay is performed at an additional charge.

 

If IFA pattern suggest GABA-B-Receptor antibody and GABA-B-R Receptor Ab antibody is positive, GABA-B-R Receptor Ab antibody IF titer assay is performed at an additional charge.

 

If IFA pattern suggest NMDA-Receptor antibody and NMDA-Receptor Ab antibody CBA is positive, NMDA-Receptor Ab antibody IF titer assay is performed at an additional charge.

 

If IFA patterns suggest PCA-1, Purkinje Cell Cytoplasmic antibody Type 1 assay is performed at an additional charge.

 

See Dementia Autoimmune Evaluation Algorithm, Serum in Special Instructions

Method Name

ANN1S, ANN2S, ANN3S, AGN1S, PCAB2, PCATR, AMPHS, CRMS, PCABP, NMDIS, AMPIS, GABIS: Indirect Immunofluorescence Assay (IFA)

VGKC, CCN, CCPQ, GANG, GD65S, ARBI: Radioimmunoassay (RIA)

WBN, ABLOT: Western Blot

AMPCS, GABCS, NMDCS, LG1CS, CS2CS: Cell Binding Assay (CBA)

NMOTS: Flow Cytometry

Reporting Name

Dementia Autoimmune Eval, S

Specimen Type

Serum


Necessary Information


Include relevant clinical information, name, phone number, mailing address, and e-mail address (if applicable) of ordering physician.



Specimen Required


Container/Tube: 

Preferred: Red top

Acceptable: Serum gel

Specimen Volume: 4 mL


Specimen Minimum Volume

2 mL

Specimen Stability Information

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

Reference Values

NEURONAL NUCLEAR ANTIBODIES

Antineuronal Nuclear Ab, Type 1 (ANNA-1)

<1:240

Antineuronal Nuclear Ab, Type 2 (ANNA-2)

<1:240

Antineuronal Nuclear Ab, Type 3 (ANNA-3)

<1:240

Anti-Glial/Neuronal Nuclear Ab, Type 1 (AGNA-1)

<1:240

 

NEURONAL AND MUSCLE CYTOPLASMIC ANTIBODIES

Purkinje Cell Cytoplasmic Ab, Type1 (PCA-1)

<1:240

Purkinje Cell Cytoplasmic Ab, Type 2 (PCA-2)

<1:240

Purkinje Cell Cytoplasmic Ab, Type Tr (PCA-Tr)

<1:240

Amphiphysin Antibody

<1:240

CRMP-5-IgG

<1:240

 

WESTERN BLOT

Paraneoplastic Western Blot

Negative

CRMP-5-IgG Western Blot

Negative

Amphiphysin Western Blot

Negative

 

ISLET CELL ANTIBODIES

Glutamic Acid Decarboxylase (GAD65) Antibody

≤0.02 nmol/L

 

CATION CHANNEL ANTIBODIES

N-Type Calcium Channel Antibody

≤0.03 nmol/L

P/Q-Type Calcium Channel Antibody

≤0.02 nmol/L

AChR Ganglionic Neuronal Antibody

≤0.02 nmol/L

Neuronal VGKC Autoantibody

≤0.02 nmol/L

 

ACHR RECEPTOR ANTIBODIES

ACh Receptor (Muscle) Binding Antibody

≤0.02 nmol/L

 

N-Methyl-D-aspartate receptor (NMDA-R) CBA

Negative

IFA: <1:120

2-amino-3-(5-methyl-3-oxo-1,2-oxazol-4-yl) propanoic acid receptor (AMPA-R) CBA

Negative

IFA: <1:120

Gamma-Amino Butyric acid-type B receptor (GABA-B-R) CBA

Negative

IFA: <1:120

Neuromyelitis Optica (NMO)/Aquaporin-4-IgG FACS Assay

Negative

LGI1-IgG CBA: Negative

CASPR2-IgG CBA: Negative

Day(s) and Time(s) Performed

ANN1S, ANN2S, ANN3S, AGN1S, PCABP, PCAB2, PCATR, AMPHS, CRMS, AMPIS, GABIS, NMDIS:

Monday through Friday; 11:30 a.m. and 8:00 p.m.; Saturday and Sunday 8:00 a.m.

 

AMPCS, GABCS, NMDCS, LG1CS, CS2CS: Monday through Friday; 6 a.m.

Paraneoplastic autoantibody Western blot confirmation, CRMP-5-IgG Western blot, Amphiphysin Western blot: Monday, Wednesday, Friday; 8 a.m.

ARBI: Monday through Friday 11:00 a.m., 6:00 p.m., and 10:00 p.m.; Saturday 6:00 a.m.; Sunday 6:00 a.m. and 10:00 a.m.

CCPQ, CCN, GANG, VGKC: Monday through Friday 11:00 a.m. and 6:00 p.m.; Saturday 6:00 a.m.; Sunday 6:00 a.m.

GD65S: Monday to Friday; 6:00 a.m. and 4:00 p.m.

Performing Laboratory

Mayo Medical Laboratories in Rochester

Test Classification

See Individual Test IDs

CPT Code Information

83519-ACh receptor (muscle) binding antibody

83519-AChR ganglionic neuronal antibody

83519-Neuronal VGKC autoantibody

83519-N-type calcium channel antibody

83519-P/Q-type calcium channel antibody

86255-AGNA-1

86255-Amphiphysin

86255-ANNA-1

86255-ANNA-2

86255-ANNA-3

86255-CRMP-5-IgG

86255-PCA-2

86255-PCA-Tr

86255-AMPAR-Ab

86255-GABAR-Ab

86255-NMDAR-Ab

86341-GAD65

86255-LG1CS

86255- CS2CS

 

86255-PCA-1 (if appropriate)

84182-Amphiphysin Western blot (if appropriate)

84182-CRMP-5 Western blot confirmation (if appropriate)

84182-Paraneoplastic autoantibody Western blot confirmation (if appropriate)

86255-NMO/AQP4-IgG FACS (if appropriate)

86256-AMPAR-Ab titer (if appropriate)

86256-GABAR-Ab titer (if appropriate)

86256-NMDAR-Ab titer (if appropriate)

86256- NMO/AQP4-IgG FACS titer (if appropriate)

LOINC Code Information

Test ID Test Order Name Order LOINC Value
DMS1 Dementia Autoimmune Eval, S In Process

 

Result ID Test Result Name Result LOINC Value
61516 NMDA-R Ab CBA, S No LOINC Needed
61518 AMPA-R Ab CBA, S No LOINC Needed
61519 GABA-B-R Ab CBA, S No LOINC Needed
34255 Dementia, Interpretation, S 69048-7
64279 LGI1-IgG CBA, S In Process
64281 CASPR2-IgG CBA, S In Process
89080 AGNA-1, S 53709-2
81722 Amphiphysin Ab, S 33927-5
80150 ANNA-1, S 13997-2
80776 ANNA-2, S 43188-2
83137 ANNA-3, S 33924-2
8338 ACh Receptor (Muscle) Binding Ab 11034-6
81184 N-Type Calcium Channel Ab 33979-6
81185 P/Q-Type Calcium Channel Ab 33980-4
83077 CRMP-5-IgG, S 35386-2
84321 AChR Ganglionic Neuronal Ab, S 42233-7
81596 GAD65 Ab Assay, S 30347-9
83138 PCA-2, S 33925-9
83076 PCA-Tr, S 33926-7
89165 Neuronal (V-G) K+ Channel Ab, S 41871-5
36349 Reflex Added No LOINC Needed

Forms

If not ordering electronically, complete, print, and send a Neurology Specialty Testing Client Test Request (T732) with the specimen (http://www.mayomedicallaboratories.com/it-mmfiles/neurology-request-form.pdf)