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Test ID MDC2 Movement Disorder, Autoimmune/Paraneoplastic Evaluation, Spinal Fluid


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 will be canceled.

 

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



Necessary Information


Provide the following information:

-Relevant clinical information

-Ordering provider name, phone number, mailing address, and e-mail address



Specimen Required


Patient Preparation: For optimal antibody detection, specimen collection is recommended before initiation of immunosuppressant medication, or corticosteroid or intravenous immunoglobulin (IVIg) treatment.

Container/Tube: Sterile vial

Preferred: Collection vial number 1

Acceptable: Any collection vial

Specimen Volume: 4 mL


Useful For

Evaluating patients with suspected paraneoplastic or other autoimmune movement disorders including patients with ataxia, brainstem encephalitis, chorea, dyskinesias, myoclonus, and parkinsonism using spinal fluid specimens

Profile Information

Test ID Reporting Name Available Separately Always Performed
MDCI Movement Disorder Interp, CSF No Yes
AMPCC AMPA-R Ab CBA, CSF No Yes
AMPHC Amphiphysin Ab, CSF No Yes
AGN1C Anti-Glial Nuclear Ab, Type 1 No Yes
ANN1C Anti-Neuronal Nuclear Ab, Type 1 No Yes
ANN2C Anti-Neuronal Nuclear Ab, Type 2 No Yes
ANN3C Anti-Neuronal Nuclear Ab, Type 3 No Yes
APBIC AP3B2 IFA, CSF No Yes
CS2CC CASPR2-IgG CBA, CSF No Yes
CRMWC CRMP-5-IgG Western Blot, CSF Yes Yes
DPPCC DPPX Ab CBA, CSF No Yes
GABCC GABA-B-R Ab CBA, CSF No Yes
GD65C GAD65 Ab Assay, CSF Yes Yes
GFAIC GFAP IFA, CSF No Yes
GRFIC GRAF1 IFA, CSF No Yes
IG5CC IgLON5 CBA, CSF No Yes
ITPIC ITPR1 IFA, CSF No Yes
K11CC KLHL11 Ab CBA, CSF Yes Yes
LG1CC LGI1-IgG CBA, CSF No Yes
GL1IC mGluR1 Ab IFA, CSF No Yes
NCDIC Neurochondrin IFA, CSF No Yes
NIFIC NIF IFA, CSF No Yes
NMDCC NMDA-R Ab CBA, CSF No Yes
PCTRC Purkinje Cell Cytoplasmc Ab Type Tr No Yes
PCA1C Purkinje Cell Cytoplasmic Ab Type 1 No Yes
PCA2C Purkinje Cell Cytoplasmic Ab Type 2 No Yes
PDEIC PDE10A Ab IFA, CSF No Yes
SP5IC Septin-5 IFA, CSF No Yes
SP7IC Septin-7 IFA, CSF No Yes
T46IC TRIM46 Ab IFA, CSF No Yes

Reflex Tests

Test ID Reporting Name Available Separately Always Performed
AGNBC AGNA-1 Immunoblot, CSF No No
AINCC Alpha Internexin CBA, CSF No No
AMPIC AMPA-R Ab IF Titer Assay, CSF No No
AMIBC Amphiphysin Immunoblot, CSF No No
AN1BC ANNA-1 Immunoblot, CSF No No
AN2BC ANNA-2 Immunoblot, CSF No No
DPPTC DPPX Ab IFA Titer, CSF No No
GABIC GABA-B-R Ab IF Titer Assay, CSF No No
GRFCC GRAF1 CBA, CSF No No
GRFTC GRAF1 IFA Titer, CSF No No
IG5TC IgLON5 IFA Titer, CSF No No
ITPCC ITPR1 CBA, CSF No No
ITPTC ITPR1 IFA Titer, CSF No No
GL1TC mGluR1 Ab IFA Titer, CSF No No
GL1CC mGluR1 Ab CBA, CSF No No
NFHCC NIF Heavy Chain CBA, CSF No No
NIFTC NIF IFA Titer, CSF No No
NFLCC NIF Light Chain CBA, CSF No No
NMDIC NMDA-R Ab IF Titer Assay, CSF No No
PC1BC PCA-1 Immunoblot, CSF No No
PCTBC PCA-Tr Immunoblot, CSF No No
AN1TC ANNA-1 Titer, CSF No No
AN2TC ANNA-2 Titer, CSF No No
AN3TC ANNA-3 Titer, CSF No No
APBCC AP3B2 CBA, CSF No No
APBTC AP3B2 IFA Titer, CSF No No
APHTC Amphiphysin Ab Titer, CSF No No
CRMTC CRMP-5-IgG Titer, CSF No No
GFACC GFAP CBA, CSF No No
GFATC GFAP IFA Titer, CSF No No
NCDCC Neurochondrin CBA, CSF No No
NCDTC Neurochondrin IFA Titer, CSF No No
PC1TC PCA-1 Titer, CSF No No
PC2TC PCA-2 Titer, CSF No No
PCTTC PCA-Tr Titer, CSF No No
PDETC PDE10A Ab IFA Titer, CSF No No
SP5CC Septin-5 CBA, CSF No No
SP5TC Septin-5 IFA Titer, CSF No No
SP7CC Septin-7 CBA, CSF No No
SP7TC Septin-7 IFA Titer, CSF No No
T46CC TRIM46 Ab CBA, CSF No No
T46TC TRIM46 Ab IFA Titer, CSF No No
AGNTC AGNA-1 Titer, CSF No No
K11TC KLHL11 Ab IFA Titer, CSF No No

Testing Algorithm

If the immunofluorescence assay (IFA) patterns suggest amphiphysin antibody, then the amphiphysin immunoblot and amphiphysin IFA titer will be performed at an additional charge.

 

If the IFA pattern suggests antiglial nuclear antibody (AGNA)-1, then 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, then the ANNA-2 immunoblot, ANNA-2 IFA titer, and ANNA-1 immunoblot will be performed at an additional charge.

 

If the client requests or the IFA pattern suggests ANNA-3 antibodies, then the ANNA-3 IFA titer will be performed at an additional charge.

 

If the IFA pattern suggests adaptor protein 3 beta 2 (AP3B2) antibodies, then the AP3B2 cell-binding assay (CBA) and AP3B2 IFA titer will be performed at an additional charge.

 

If the collapsin response-mediator protein-5 (CRMP-5)-IgG Western blot is positive, then the CRMP-5-IgG IFA titer will be performed at an additional charge.

 

If the IFA pattern suggests Purkinje cytoplasmic antibody type 1 (PCA-1), then the PCA-1 IB and PCA-1 IFA titer will be performed at an additional charge.

 

If the IFA pattern suggests PCA-Tr, then the PCA-Tr IB and PCA-Tr IFA titer will be performed at an additional charge.

 

If the IFA pattern suggests PCA-2 antibody, then the PCA-2 IFA titer will be performed at an additional charge.

 

If the alpha-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid (AMPA)-receptor CBA result is positive, then AMPA-receptor antibody IFA titer will be performed at an additional charge.

 

If the dipeptidyl-peptidase-like protein-6 (DPPX) antibody CBA is positive, then DPPX antibody IFA titer will be performed at an additional charge.

 

If the gamma-aminobutyric acid B (GABA-B)-receptor CBA result is positive, then the GABA-B-receptor antibody IFA titer will be performed at an additional charge.

 

If the IFA pattern suggests glial fibrillary acidic protein (GFAP) antibody, then the GFAP antibody CBA and GFAP antibody IFA titer will be performed at an additional charge.

 

If the IFA pattern suggests metabotropic glutamate receptor 1 (mGluR1) antibody, then the mGluR1 CBA and mGluR1 antibody IFA titer will be performed at an additional charge.

 

If the N-methyl-D-aspartate (NMDA)-receptor CBA result is positive, then the NMDA-receptor antibody IFA titer will be performed at an additional charge.

 

If the IFA pattern suggests GTPase regulator associated with focal adhesion kinase-1 (GRAF1) antibody, then the GRAF1 CBA and GRAF1 antibody IFA titer will be performed at an additional charge.

 

If the IgLON5 antibody CBA result is positive, then the IgLON5 antibody IFA titer will be performed at an additional charge.

 

If the IFA pattern suggests inositol 1,4,5-trisphosphate receptor (ITPR1) antibody, then the ITPR1 CBA and ITPR1 antibody 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 antibody IFA titer will be performed at an additional charge.

 

If the Kelch-like protein 11 (KLHL11) CBA result is reactive, then the KLHL11 antibody 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 septin-5 antibody, then the septin-5 CBA and septin-5 IFA titer will be performed at an additional charge.

 

If the IFA pattern suggests septin-7 antibody, then the septin-7 CBA and septin-7 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 Movement Disorder Evaluation Algorithm-Spinal Fluid

Central Nervous System Demyelinating Disease Diagnostic Algorithm

Method Name

GRFIC, GRFTC, K11TC, AGN1C, AGNTC, AMPIC, AMPHC, APHTC, ANN1C, AN1TC, ANN2C, AN2TC, ANN3C, AN3TC, APBIC, APBTC, CRMTC, DPPTC, GABIC, GFAIC, GFATC, IG5TC, ITPIC, ITPTC, GL1IC, GL1TC, NCDIC, NCDTC, NIFIC, NIFTC, NMDIC, PCA1C, PC1TC, PCA2C, PC2TC, PCTRC, PCTTC, PDEIC, PDETC, SP5IC, SP5TC, SP7IC, SP7TC, T46IC, T46TC: Indirect Immunofluorescence Assay (IFA)

 

GRFCC, K11CC, AMPCC, APBCC, CS2CC, DPPCC, GABCC, GFACC, IG5CC, ITPCC, LG1CC, GL1CC, NCDCC, AINCC, NFLCC, NFHCC, NMDCC, SP5CC, SP7CC, T46CC: Cell Binding Assay (CBA)

 

CRMWC: Western Blot (WB)

 

AGNBC, AMIBC, AN1BC, AN2BC, PC1BC, PCTBC: Immunoblot (IB)

 

GD65C: Radioimmunoassay (RIA)

 

MDCI: Medical Interpretation

Reporting Name

Movement, Autoimm/Paraneo, CSF

Specimen Type

CSF

Specimen Minimum Volume

2 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
CSF Refrigerated (preferred) 28 days
  Frozen  28 days
  Ambient  72 hours

Reference Values

Test ID

Reporting name

Methodology*

Reference value

MDCI

Movement Disorder Interp, CSF

Medical interpretation

Interpretive report

AMPCC

AMPA-R Ab CBA, CSF

CBA

Negative

AMPHC

Amphiphysin Ab, CSF

IFA

Negative

AGN1C

Anti-Glial Nuclear Ab, Type 1

IFA

Negative

ANN1C

Anti-Neuronal Nuclear Ab, Type 1

IFA

Negative

ANN2C

Anti-Neuronal Nuclear Ab, Type 2

IFA

Negative

ANN3C

Anti-Neuronal Nuclear Ab, Type 3

IFA

Negative

APBIC

AP3B2 IFA, CSF

IFA

Negative

CS2CC

CASPR2-IgG CBA, CSF

CBA

Negative

CRMWC

CRMP-5-IgG Western Blot, CSF

WB

Negative

DPPCC

DPPX Ab CBA, CSF

CBA

Negative

GABCC

GABA-B-R Ab CBA, CSF

CBA

Negative

GD65C

GAD65 Ab Assay, CSF

RIA

≤0.02 nmol/L
Reference values apply to all ages.

GRFIC

GRAF1 IFA, CSF

IFA

Negative

GFAIC

GFAP IFA, CSF

IFA

Negative

IG5CC

IgLON5 CBA, CSF

CBA

Negative

ITPIC

ITPR1 IFA, CSF

IFA

Negative

K11CC

KLHL11 Ab CBA, CSF

CBA

Negative

LG1CC

LGI1-IgG CBA, CSF

CBA

Negative

GL1IC

mGluR1 Ab IFA, CSF

IFA

Negative

NCDIC

Neurochondrin IFA, CSF

IFA

Negative

NIFIC

NIF IFA, CSF

IFA

Negative

NMDCC

NMDA-R Ab CBA, CSF

CBA

Negative

PCTRC

Purkinje Cell Cytoplasmic Ab Type Tr

IFA

Negative

PCA1C

Purkinje Cell Cytoplasmic Ab Type 1

IFA

Negative

PCA2C

Purkinje Cell Cytoplasmic Ab Type 2

IFA

Negative

PDEIC

PDE10A Ab IFA, CSF

IFA

Negative

SP5IC

Septin-5 IFA, CSF

IFA

Negative

SP7IC

Septin-7 IFA, CSF

IFA

Negative

T46IC

TRIM46 IFA, CSF

IFA

Negative

 

Reflex Information:

Test ID

Reporting name

Methodology*

Reference value

AGNBC

AGNA-1 Immunoblot, CSF

IB

Negative

AGNTC

AGNA-1 Titer, CSF

IFA

<1:2

AINCC

Alpha Internexin CBA, CSF

CBA

Negative

AMPIC

AMPA-R Ab IF Titer Assay, CSF

IFA

<1:2

AMIBC

Amphiphysin Immunoblot, CSF

IB

Negative

AN1BC

ANNA-1 Immunoblot, CSF

IB

Negative

AN1TC

ANNA-1 Titer, CSF

IFA

<1:2

AN2BC

ANNA-2 Immunoblot, CSF

IB

Negative

AN2TC

ANNA-2 Titer, CSF

IFA

<1:2

AN3TC

ANNA-3 Titer, CSF

IFA

<1:2

APBCC

AP3B2 CBA, CSF

CBA

Negative

APBTC

AP3B2 IFA Titer, CSF

IFA

<1:2

APHTC

Amphiphysin Ab Titer, CSF

IFA

<1:2

CRMTC

CRMP-5-IgG Titer, CSF

IFA

<1:2

DPPTC

DPPX Ab IFA Titer, CSF

IFA

<1:2

GABIC

GABA-B-R Ab IF Titer Assay, CSF

IFA

<1:2

GFACC

GFAP CBA, CSF

CBA

Negative

GFATC

GFAP IFA Titer, CSF

IFA

<1:2

GRFCC

GRAF1 CBA, CSF

CBA

Negative

GRFTC

GRAF1 IFA Titer, CSF

IFA

<1:2

IG5TC

IgLON5 IFA Titer, CSF

IFA

<1:2

ITPCC

ITPR1 CBA, CSF

CBA

Negative

ITPTC

ITPR1 IFA Titer, CSF

IFA

<1:2

K11TC

KLHL11 Ab IFA Titer, CSF

IFA

<1:2

GL1TC

mGluR1 Ab IFA Titer, CSF

IFA

<1:2

GL1CC

mGluR1 Ab CBA, CSF

CBA

Negative

NCDCC

Neurochondrin CBA, CSF

CBA

Negative

NCDTC

Neurochondrin IFA Titer, CSF

IFA

<1:2

NFHCC

NIF Heavy Chain CBA, CSF

CBA

Negative

NIFTC

NIF IFA Titer, CSF

IFA

<1:2

NFLCC

NIF Light Chain CBA, CSF

CBA

Negative

NMDIC

NMDA-R Ab IF Titer Assay, CSF

IFA

<1:2

PC1BC

PCA-1 Immunoblot, CSF

IB

Negative

PC1TC

PCA-1 Titer, CSF

IFA

<1:2

PC2TC

PCA-2 Titer, CSF

IFA

<1:2

PCTTC

PCA-Tr Titer, CSF

IFA

<1:2

PCTBC

PCA-Tr Immunoblot, CSF

IB

Negative

PDETC

PDE10A Ab IFA Titer, CSF

IFA

<1:2

SP5CC

Septin-5 CBA, CSF

CBA

Negative

SP5TC

Septin-5 IFA Titer, CSF

IFA

<1:2

SP7CC

Septin-7 CBA, CSF

CBA

Negative

SP7TC

Septin-7 IFA Titer, CSF

IFA

<1:2

T46CC

TRIM46 CBA, CSF

CBA

Negative

T46TC

TRIM46 IFA Titer, CSF

IFA

<1:2

 

*Methodology abbreviations:

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."

Day(s) Performed

Profile tests: Monday through Sunday; Reflex tests: Varies

Report Available

8 to 12 days

Performing Laboratory

Mayo Clinic Laboratories in Rochester

CPT Code Information

86255 x26

84182

86341

0432U

84182-AGNBC (if appropriate)

86256-GNTC (if appropriate)

86255-AINCC (if appropriate)

84182-AMIBC (if appropriate)

86256-AMPIC (if appropriate)

84182-AN1BC (if appropriate)

86256-AN1TC (if appropriate)

84182-AN2BC (if appropriate)

86256-AN2TC (if appropriate)

86256-AN3TC (if appropriate)

86255-APBCC (if appropriate)

86256-APBTC (if appropriate)

86256-APHTC (if appropriate)

86256-CRMTC (if appropriate)

86256-DPPTC (if appropriate)

86256-GABIC (if appropriate)

86255-GFACC (if appropriate)

86256-GFATC (if appropriate)

86255-GL1CC (if appropriate)

86256-GL1TC (if appropriate)

86255-GRFCC (if appropriate)

86256-GRFTC (if appropriate)

86256-IG5TC (if appropriate)

86255-ITPCC (if appropriate)

86256-ITPTC (if appropriate)

86256-K11TC (if appropriate)

86255-NCDCC (if appropriate)

86256-NCDTC (if appropriate)

86255-NFHCC (if appropriate)

86255-NFLCC (if appropriate)

86256-NIFTC (if appropriate)

86256-NMDIC (if appropriate)

84182-PC1BC (if appropriate)

86256-PC1TC (if appropriate)

86256-PC2TC (if appropriate)

84182-PCTBC (if appropriate)

86256-PCTTC (if appropriate)

86256-PDETC (if appropriate)

86255-SP5CC (if appropriate)

86256-SP5TC (if appropriate)

86255-SP7CC (if appropriate)

86256-SP7TC (if appropriate)

86255-T46CC (if appropriate)

86256-T46TC (if appropriate)

LOINC Code Information

Test ID Test Order Name Order LOINC Value
MDC2 Movement, Autoimm/Paraneo, CSF 94712-7

 

Result ID Test Result Name Result LOINC Value
61513 NMDA-R Ab CBA, CSF 93502-3
61514 AMPA-R Ab CBA, CSF 93491-9
61515 GABA-B-R Ab CBA, CSF 93426-5
606959 GRAF1 IFA, CSF 96473-4
606965 NIF IFA, CSF 96490-8
606951 IgLON5 CBA, CSF 96481-7
610580 KLHL11 Ab CBA, CSF 99073-9
615862 AP3B2 IFA, CSF 101907-4
615866 Neurochondrin IFA, CSF 101451-3
615874 Septin-7 IFA, CSF 101464-6
615870 Septin-5 IFA, CSF 101461-2
620067 PDE10A Ab IFA, CSF 103842-1
616446 TRIM46 Ab IFA, CSF 103843-9
605156 GFAP IFA, CSF 94360-5
606953 ITPR1 IFA, CSF 96467-6
64280 LGI1-IgG CBA, CSF 94288-8
64282 CASPR2-IgG CBA, CSF 94286-2
64927 mGluR1 Ab IFA, CSF 94361-3
64934 DPPX Ab CBA, CSF 94283-9
601997 Movement Disorder Interp, CSF 69048-7
89079 AGNA-1, CSF 90827-7
5906 Amphiphysin Ab, CSF 90815-2
3852 ANNA-1, CSF 44768-0
7472 ANNA-2, CSF 56959-0
21633 ANNA-3, CSF 90836-8
3988 PCA-1, CSF 90841-8
21632 PCA-2, CSF 90843-4
21631 PCA-Tr, CSF 90845-9
21747 CRMP-5-IgG Western Blot, CSF 53707-6
21702 GAD65 Ab Assay, CSF 94359-7
618902 IFA Notes 48767-8

Test 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.