Specimen:

CSF

Collection Medium:

Minimum:

4 mL spinal fluid (CSF)

Analytic Time:

2 weeks

Reference Range:

ANTINEURONAL NUCLEAR ANTIBODY-Type 1 (ANNA-1)
   Negative at <1:2
ANTINEURONAL NUCLEAR ANTIBODY-Type 2 (ANNA-2)
   Negative at <1:2
ANTINEURONAL NUCLEAR ANTIBODY-Type 3 (ANNA-3)
   Negative at <1:2
PURKINJE CELL CYTOPLASMIC ANTIBODY, Type 1 (PCA-1)
   Negative at <1:2
PURKINJE CELL CYTOPLASMIC ANTIBODY, Type 2 (PCA-2)
   Negative at <1:2
PURKINJE CELL CYTOPLASMIC ANTIBODY, Type Tr (PCA-Tr)
   Negative at <1:2
AMPHIPHYSIN ANTIBODY
   Negative at <1:2
CRMP-5-IgG
Negative at <1:2

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 the Clinical Pathology Core Laboratory 
at 356-3527 to request CRMP-5 Western blot.

Neuron-restricted patterns of IgG staining that do not fulfill criteria 
for the listed autoantibodies may be reported as "unclassified 
antineuronal IgG." If detected, newly identified autoantibody 
specificities may be reported. Complex patterns that include 
non-neuronal elements may be reported as "uninterpretable."

Comments:

Testing Algorithm
If IFA is indeterminate, paraneoplastic autoantibody Western blot is 
performed at an additional charge.

If IFA pattern is suggestive of neuromyelitis optica (NMO), then 
NMO-IgG 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 GAD65 antibody, GAD65 antibody 
radioimmunoprecipitation assay is performed at an additional charge.

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

Methodology:

Indirect Immunofluorescence Assay (IFA)
Radioimmunoprecipitation Assay (RIA)
Western Blot

CPT Code:

86256 AGNAC, 86256 Amphiphysin, 86256 ANNA-1, 86256 ANNA-2,
86256 ANNA-3, 86256 CRMP-5-IgG, 86256 PCA-1, 86256 PCA-2,
86256 PCA-Tr, 84182 Paraneoplastic autoantibody Western blot
   confirmation (if appropriate),
84182 CRMP5 Western blot confirmation (if appropriate),
86341 GAD65 confirmation (if appropriate)
84182 Amphiphysin Western Blot confirmation (if appropriate)

See also:
Paraneoplastic Autoantibody Evaluation, Serum