Test Code DYS2 Dysautonomia, Autoimmune/Paraneoplastic Evaluation, Serum
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 test will be canceled.
For a list of antibodies performed with each evaluation, see Autoimmune Neurology Antibody Matrix.
This test should not be requested for patients who have recently received radioisotopes, therapeutically or diagnostically, because of potential assay interference. The specific waiting period before specimen collection will depend on the isotope administered, the dose given, and the clearance rate in the individual patient. Specimens will be screened for radioactivity prior to analysis. Radioactive specimens received in the laboratory will be held for 1 week and assayed if sufficiently decayed or canceled if radioactivity remains.
Necessary Information
Provide the following information:
-Relevant clinical information
-Ordering healthcare professional's name, phone number, mailing address, and email address
Specimen Required
Patient Preparation: For optimal antibody detection, collect specimen before starting immunosuppressant medication or intravenous immunoglobulin treatment.
Supplies: Sarstedt Aliquot Tube, 5 mL (T914)
Collection Container/Tube:
Preferred: Red top
Acceptable: Serum gel
Submission Container/Tube: Plastic vial
Specimen Volume: 4 mL Serum
Collection Instructions: Centrifuge and aliquot serum into a plastic vial.
Secondary ID
92121Useful For
Investigating idiopathic dysautonomic symptoms
Directing a focused search for cancer in patients with idiopathic dysautonomia
Investigating autonomic symptoms that appear in the course or wake of cancer therapy and are not explainable by recurrent cancer or metastasis (detection of autoantibodies in this profile helps differentiate autoimmune dysautonomia from the effects of chemotherapy)
Profile Information
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| ADEI | Dysautonomia, Interpretation, S | No | Yes |
| AAGFS | AChR Alpha3 Ganglionic Flow, S | No | Yes |
| ANN1S | Anti-Neuronal Nuclear Ab, Type 1 | No | Yes |
| APBIS | AP3B2 IFA, S | No | Yes |
| CRMS | CRMP-5-IgG, S | No | Yes |
| CS2CS | CASPR2-IgG CBA, S | No | Yes |
| DPPCS | DPPX Ab CBA, S | No | Yes |
| LG1CS | LGI1-IgG CBA, S | No | Yes |
| PCAB2 | Purkinje Cell Cytoplasmic Ab Type 2 | No | Yes |
Reflex Tests
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| AN1BS | ANNA-1 Immunoblot, S | No | No |
| AN2BS | ANNA-2 Immunoblot, S | No | No |
| AN1TS | ANNA-1 Titer, S | No | No |
| APBCS | AP3B2 CBA, S | No | No |
| AAGTS | AChR Alpha3 Gang Flow Titer, S | No | No |
| CRMTS | CRMP-5-IgG Titer, S | No | No |
| DPPTS | DPPX Ab IFA Titer, S | No | No |
| MP1BS | MAP1B Immunoblot, S | No | No |
| PC2TS | PCA-2 Titer, S | No | No |
| CRMWS | CRMP-5-IgG Western Blot, S | No | No |
| APBTS | AP3B2 IFA Titer, S | No | No |
Testing Algorithm
If the ganglionic acetylcholine receptor (alpha 3) flow screen assay result requires further investigation, then the Alpha3 flow titration assay will be performed at an additional charge.
If the indirect immunofluorescence assay (IFA) patterns suggest collapsin response-mediator protein (CRMP)-5-IgG, then the CRMP-5-IgG IFA titer and CRMP-5-IgG Western blot 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 adaptor protein 3 beta 2 (AP3B2) antibody, then the AP3B2 cell-binding assay (CBA) and AP3B2 IFA titer will be performed at an additional charge.
If the dipeptidyl-peptidase-like protein-6 antibody (DPPX) antibody CBA result is positive, then DPPX IFA titer will be performed at an additional charge.
If the IFA pattern suggests Purkinje cell cytoplasmic antibody type 2 (PCA-2), then the PCA-2 titer and microtubule-associated protein 1B (MAP1B) immunoblot will be performed at an additional charge.
For more information see Autoimmune/Paraneoplastic Dysautonomia Evaluation Algorithm.
Method Name
ANN1S, APBIS, CRMS, PCAB2, AN1TS, APBTS, CRMTS, DPPTS, PC2TS: Indirect Immunofluorescence Assay (IFA)
CS2CS, DPPCS, LG1CS, APBCS: Cell Binding Assay (CBA)
CRMWS: Western Blot (WB)
AN1BS, AN2BS, MP1BS: Immunoblot (IB)
AAGFS, AAGTS: Flow Cytometry
ADEI: Technical Interpretation
Reporting Name
Dysautonomia, Autoimm/Paraneo, SSpecimen Type
SerumSpecimen Minimum Volume
Serum: 2.5 mL
Specimen Stability Information
| Specimen Type | Temperature | Time |
|---|---|---|
| Serum | 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 |
|
ADEI |
Dysautonomia, Interpretation, S |
Technical interpretation |
Interpretive report |
|
AAGFS |
AChR Alpha3 Ganglionic Flow, S |
FC |
Negative |
|
ANN1S |
Anti-Neuronal Nuclear Ab, Type 1 |
IFA |
Negative |
|
APBIS |
AP3B2 IFA, S |
IFA |
Negative |
|
CS2CS |
CASPR2-IgG CBA, S |
CBA |
Negative |
|
CRMS |
CRMP-5-IgG, S |
IFA |
Negative |
|
DPPCS |
DPPX Ab CBA, S |
CBA |
Negative |
|
LG1CS |
LGI1-IgG CBA, S |
CBA |
Negative |
|
PCAB2 |
Purkinje Cell Cytoplasmic Ab Type 2 |
IFA |
Negative |
Reflex Information:
|
Test ID |
Reporting name |
Methodology* |
Reference value |
|
AAGTS |
AChR Alpha3 Gang Flow Titer, S |
FC |
<1:10 |
|
AN1BS |
ANNA-1 Immunoblot, S |
IB |
Negative |
|
AN1TS |
ANNA-1 Titer, S |
IFA |
<1:240 |
|
AN2BS |
ANNA-2 Immunoblot, S |
IB |
Negative |
|
APBCS |
AP3B2 CBA, S |
CBA |
Negative |
|
APBTS |
AP3B2 IFA Titer, S |
IFA |
<1:240 |
|
CRMTS |
CRMP-5-IgG Titer, S |
IFA |
<1:240 |
|
CRMWS |
CRMP-5-IgG Western Blot, S |
WB |
Negative |
|
DPPTS |
DPPX Ab IFA Titer, S |
IFA |
<1:240 |
|
MP1BS |
MAP1B Immunoblot, S |
IB |
Negative |
|
PC2TS |
PCA-2 Titer, S |
IFA |
<1:240 |
*Methodology abbreviations:
Cell-binding assay (CBA)
Flow cytometry (FC)
Immunoblot (IB)
Immunofluorescence assay (IFA)
Western Blot (WB)
Day(s) Performed
Report Available
8 to 12 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. It has not been cleared or approved by the US Food and Drug Administration.CPT Code Information
86255 x 8
86256 AAGTS (if appropriate)
84182 AN1BS (if appropriate)
86256 AN1TS (if appropriate)
84182 AN2BS (if appropriate)
86255 APBCS (if appropriate)
86256 APBTS (if appropriate)
86256 CRMTS (if appropriate)
84182 CRMWS (if appropriate)
86256 DPPTS (if appropriate)
84182 MP1BS (if appropriate)
86256 PC2TS (if appropriate)
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| DYS2 | Dysautonomia, Autoimm/Paraneo, S | 99000-2 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| 80150 | ANNA-1, S | 33615-6 |
| 83077 | CRMP-5-IgG, S | 72504-4 |
| 83138 | PCA-2, S | 84925-7 |
| 34270 | Dysautonomia, Interpretation, S | 69048-7 |
| 64279 | LGI1-IgG CBA, S | 94287-0 |
| 64281 | CASPR2-IgG CBA, S | 94285-4 |
| 64933 | DPPX Ab CBA, S | 94676-4 |
| 615863 | AP3B2 IFA, S | 101907-4 |
| 622854 | AChR Alpha3 Ganglionic Flow, S | In Process |
| 618892 | IFA Notes | 48767-8 |