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HelpTest Code PAC1 Paraneoplastic, Autoantibody Evaluation, Spinal Fluid
Additional Codes
ALAB: YP3
Powerchart: Paraneoplastic Antibody Evaluation, CSF
MA Cerner: Paraneoplastic, Autoantibody Evaluation, CSF
Useful For
Aids in the diagnosis of paraneoplastic neurological autoimmune disorders related to carcinoma of lung, breast, ovary, thymoma, or Hodgkin lymphoma in spinal fluid specimens
Profile Information
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| PNEOI | Paraneoplastic Interpretation, 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 |
| CRMC | CRMP-5-IgG, 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 |
Testing Algorithm
If indirect immunofluorescence assay (IFA) pattern suggests antiglial nuclear antibody-1 (AGNA-1) antibody, then AGNA-1 immunoblot is performed at an additional charge.
If IFA pattern suggests antineuronal nuclear antibodies (ANNA)-1 antibody, then ANNA-1 immunoblot is performed at an additional charge.
If IFA pattern suggests ANNA-2 antibody, then ANNA-2 immunoblot is performed at an additional charge.
If IFA pattern suggests Purkinje cytoplasmic antibody (PCA)-1 antibody, then PCA-1 immunoblot is performed at an additional charge.
If IFA pattern suggests PCA-Tr antibody, then PCA-Tr immunoblot is performed at an additional charge.
If IFA patterns suggest collapsin response-mediator protein (CRMP)-5-IgG, then CRMP-5-IgG Western blot is performed at an additional charge.
If IFA patterns suggest glutamic acid decarboxylase 65 (GAD65) antibody, then GAD65 antibody radioimmunoassay (RIA) is performed at an additional charge.
If IFA patterns suggest neuronal voltage-gated potassium channel-complex (VGKC) autoantibody, then VGKC-complex antibody RIA is performed at an additional charge.
If VGKC-complex antibody RIA result is greater than 0.00 nmol/L, then leucine-rich, glioma inactivated 1 (LGI1)-IgG cell-binding assay (CBA) and contactin-associated protein-like 2 (CASPR2)-IgG CBA are performed at an additional charge.
If IFA patterns suggest amphiphysin antibody, then amphiphysin immunoblot is performed at an additional charge.
If IFA pattern suggests N-methyl-D-aspartate (NMDA)-receptor, then NMDA-receptor antibody CBA and/or NMDA-receptor antibody IFA titer is performed at an additional charge.
If IFA pattern suggests alpha-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid (AMPA)-receptor, then AMPA-Receptor antibody CBA and/or AMPA-receptor antibody IFA titer is performed at an additional charge.
If IFA pattern suggests gamma-aminobutyric acid B (GABA-B)-receptor, then GABA-B-receptor antibody CBA and/or GABA-B-Receptor antibody IFA titer is performed at an additional charge.
If IFA pattern suggests dipeptidyl-peptidase-like protein-6 antibody (DPPX), then DPPX antibody CBA and DPPX antibody IFA titer is performed at an additional charge.
If IFA pattern suggests metabotropic glutamate receptor 1 (mGluR1), then mGluR1 antibody CBA and mGluR1 antibody IFA titer is performed at an additional charge.
For more information. the following algorithms are available:
Special Instructions
Method Name
AGN1C, AMPHC, AMPIC, ANN1C, ANN2C, ANN3C, CRMC, DPPIC, DPPTC, GABIC, GL1IC, GL1TC, NMDIC, PCA1C, PCA2C, PCTRC: Indirect Immunofluorescence Assay (IFA)
CRMWC: Western Blot
AGNBC, AMIBC, AN1BC, AN2BC, PC1BC, PCTBC: Immunoblot (IB)
GD65C, VGKCC: Radioimmunoassay (RIA)
AMPCC, CS2CC, DPPCC, GABCC, GL1CC, LG1CC, NMDCC: Cell-Binding Assay (CBA)
Reporting Name
Paraneoplas Autoantibody Eval,CSFSpecimen Type
CSFAdditional Testing Requirements
In patients with a history of tobacco use or other lung cancer risk, or if thymoma is suspected, PAVAL / Paraneoplastic Autoantibody Evaluation, Serum is also recommended.
Necessary Information
Provide the following information:
-Relevant clinical information
-Ordering provider name, phone number, mailing address, and e-mail address
Specimen Required
Container/Tube: Sterile vial
Specimen Volume: 4 mL
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 |
Reject Due To
| Gross hemolysis | Reject |
| Gross lipemia | Reject |
| Gross icterus | Reject |
Reference Values
|
Test ID |
Reporting name |
Methodology |
Reference value |
|
AMPHC |
Amphiphysin Ab, CSF |
Indirect immunofluorescence (IFA) |
<1:2 |
|
AGN1C |
Anti-Glial Nuclear Ab, Type 1 |
IFA |
<1:2 |
|
ANN1C |
Anti-Neuronal Nuclear Ab, Type 1 |
IFA |
<1:2 |
|
ANN2C |
Anti-Neuronal Nuclear Ab, Type 2 |
IFA |
<1:2 |
|
ANN3C |
Anti-Neuronal Nuclear Ab, Type 3 |
IFA |
<1:2 |
|
CRMC |
CRMP-5-IgG, CSF |
IFA |
<1:2 |
|
PCTRC |
Purkinje Cell Cytoplasmc Ab Type Tr |
IFA |
<1:2 |
|
PCA1C |
Purkinje Cell Cytoplasmic Ab Type 1 |
IFA |
<1:2 |
|
PCA2C |
Purkinje Cell Cytoplasmic Ab Type 2 |
IFA |
<1:2 |
Reflex Information:
|
Test ID |
Reporting name |
Methodology |
Reference value |
|
AGNBC |
AGNA-1 Immunoblot, CSF |
Immunoblot (IB) |
Negative |
|
AMPCC |
AMPA-R Ab CBA, CSF |
Cell-binding assay (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 |
|
AN2BC |
ANNA-2 Immunoblot, CSF |
IB |
Negative |
|
CRMWC |
CRMP-5-IgG Western Blot, CSF |
Western blot (WB) |
Negative |
|
CS2CC |
CASPR2-IgG CBA, CSF |
CBA |
Negative |
|
DPPCC |
DPPX Ab CBA, CSF |
CBA |
Negative |
|
DPPIC |
DPPX Ab IFA, CSF |
IFA |
Negative |
|
DPPTC |
DPPX Ab IFA Titer, CSF |
IFA |
<1:2 |
|
GABCC |
GABA-B-R Ab CBA, CSF |
CBA |
Negative |
|
GABIC |
GABA-B-R Ab IF Titer Assay, CSF |
IFA |
<1:2 |
|
GD65C |
GAD65 Ab Assay, CSF |
Radioimmunoassay (RIA) |
≤0.02 nmol/L |
|
LG1CC |
LGI1-IgG CBA, CSF |
CBA |
Negative |
|
GL1CC |
mGluR1 Ab CBA, CSF |
CBA |
Negative |
|
GL1IC |
mGluR1 Ab IFA, CSF |
IFA |
Negative |
|
GL1TC |
mGluR1 Ab IFA Titer, CSF |
IFA |
<1:2 |
|
NMDCC |
NMDA-R Ab CBA, CSF |
CBA |
Negative |
|
NMDIC |
NMDA-R Ab IF Titer Assay, CSF |
IFA |
<1:2 |
|
PC1BC |
PCA-1 Immunoblot, CSF |
IB |
Negative |
|
PCTBC |
PCA-Tr Immunoblot, CSF |
IB |
Negative |
|
VGKCC |
VGKC-complex Ab IPA, CSF |
RIA |
≤0.02 nmol/L |
Neuron-restricted patterns of IgG staining that do not fulfill criteria for amphiphysin, ANNA-1, ANNA-2, ANNA-3, AGNA-1, PCA-1, PCA-2, PCA-Tr, or CRMP-5-IgG may be reported as "unclassified antineuronal IgG." Complex patterns that include non-neuronal elements may be reported as "uninterpretable."
Note: Titers lower than 1:2 are detectable by recombinant CRMP-5 Western blot analysis. CRMP-5 Western blot analysis will be done on request on stored spinal fluid (held 4 weeks). This supplemental testing is recommended in cases of chorea, vision loss, cranial neuropathy, and myelopathy. Call 800-533-1710 to request CRMP-5 Western blot.
Day(s) Performed
Profile tests: Monday through Sunday; Reflex tests: Varies
Report Available
5 to 10 daysPerforming Laboratory
Mayo Clinic Laboratories in Rochester
Test Classification
This test was developed, and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the US Food and Drug Administration.CPT Code Information
86255 x 9
84182-AGNBC (if appropriate)
86255-AMPCC (if appropriate)
86256-AMPIC (if appropriate)
84182-AMIBC (if appropriate)
84182-AN1BC (if appropriate)
84182-AN2BC (if appropriate)
86255-CS2CC (if appropriate)
84182-CRMWC (if appropriate)
86255-DPPCC (if appropriate)
86256-DPPTC (if appropriate)
86255-DPPIC (if appropriate)
86255-GABCC (if appropriate)
86256-GABIC (if appropriate)
86341-GD65C (if appropriate)
86255-LG1CC (if appropriate)
86255-GL1CC (if appropriate)
86256-GL1TC (if appropriate)
86255-GL1IC (if appropriate)
86255-NMDCC (if appropriate)
86256-NMDIC (if appropriate)
84182-PC1BC (if appropriate)
84182-PCTBC (if appropriate)
83519-VGKCC (if appropriate)
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| PAC1 | Paraneoplas Autoantibody Eval,CSF | 94818-2 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| 89079 | AGNA-1, CSF | 94355-5 |
| 5906 | Amphiphysin Ab, CSF | 94354-8 |
| 3852 | ANNA-1, CSF | 94356-3 |
| 7472 | ANNA-2, CSF | 94357-1 |
| 21633 | ANNA-3, CSF | 94358-9 |
| 21650 | CRMP-5-IgG, CSF | 94706-9 |
| 3988 | PCA-1, CSF | 94363-9 |
| 21632 | PCA-2, CSF | 94364-7 |
| 21631 | PCA-Tr, CSF | 94362-1 |
| 34271 | Paraneoplastic Interpretation, CSF | 69048-7 |
| 36429 | Reflex Added | 77202-0 |
Reflex Tests
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| AGNBC | AGNA-1 Immunoblot, CSF | No | No |
| AMPCC | AMPA-R Ab 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 |
| CS2CC | CASPR2-IgG CBA, CSF | No | No |
| CRMWC | CRMP-5-IgG Western Blot, CSF | Yes | No |
| DPPCC | DPPX Ab CBA, CSF | No | No |
| DPPTC | DPPX Ab IFA Titer, CSF | No | No |
| DPPIC | DPPX Ab IFA, CSF | No | No |
| GABCC | GABA-B-R Ab CBA, CSF | No | No |
| GABIC | GABA-B-R Ab IF Titer Assay, CSF | No | No |
| GD65C | GAD65 Ab Assay, CSF | Yes | No |
| LG1CC | LGI1-IgG CBA, CSF | No | No |
| GL1CC | mGluR1 Ab CBA, CSF | No | No |
| GL1TC | mGluR1 Ab IFA Titer, CSF | No | No |
| GL1IC | mGluR1 Ab IFA, CSF | No | No |
| NMDCC | NMDA-R Ab 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 |
| VGKCC | VGKC-complex Ab IPA, CSF | No | No |
Secondary ID
37430Forms
If not ordering electronically, complete, print, and send a Neurology Specialty Testing Client Test Request (T732) with the specimen.