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:

CRMP-5-IgG Western blot is also performed by specific request for more 
sensitive detection of CRMP-5-IgG. Testing should be requested in cases 
of subacute basal ganglionic disorders (chorea, Parkinsonism), cranial 
neuropathies (especially loss of vision, taste, or smell), and 
myelopathies.

GAD65 maybe reflexed if necessary.  An additional charge would occur 
for this confirmation.

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)

See also:
Paraneoplastic Autoantibody Evaluation, Serum