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Test Code MAS1 Myelopathy, 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, see 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

605125

Useful For

Evaluating patients with suspected autoimmune myelopathy, myelitis, and paraneoplastic myelopathy using serum specimens

Profile Information

Test ID Reporting Name Available Separately Always Performed
MSI1 Autoimmune Myelopathy Interp, S No Yes
AMPHS Amphiphysin Ab, S No Yes
AGN1S Anti-Glial Nuclear Ab, Type 1 No Yes
ANN1S Anti-Neuronal Nuclear Ab, Type 1 No Yes
ANN2S Anti-Neuronal Nuclear Ab, Type 2 No Yes
ANN3S Anti-Neuronal Nuclear Ab, Type 3 No Yes
APBIS AP3B2 IFA, S No Yes
CRMS CRMP-5-IgG, S No Yes
DPPCS DPPX Ab CBA, S No Yes
GABCS GABA-B-R Ab CBA, S No Yes
GD65S GAD65 Ab Assay, S Yes Yes
GL1IS mGluR1 Ab IFA, S No Yes
MOGFS MOG FACS, S Yes Yes
NCDIS Neurochondrin IFA, S No Yes
NMOFS NMO/AQP4 FACS, S Yes Yes
PCABP Purkinje Cell Cytoplasmic Ab Type 1 No Yes
PCAB2 Purkinje Cell Cytoplasmic Ab Type 2 No Yes
SP7IS Septin-7 IFA, S No Yes
T46IS TRIM46 Ab IFA, S No Yes

Reflex Tests

Test ID Reporting Name Available Separately Always Performed
AGNBS AGNA-1 Immunoblot, S No No
AMIBS Amphiphysin Immunoblot, S No No
AN1BS ANNA-1 Immunoblot, S No No
AN2BS ANNA-2 Immunoblot, S No No
DPPTS DPPX Ab IFA Titer, S No No
GABIS GABA-B-R Ab IF Titer Assay, S No No
GL1CS mGluR1 Ab CBA, S No No
GL1TS mGluR1 Ab IFA Titer, S No No
MOGTS MOG FACS Titer, S No No
NMOTS NMO/AQP4 FACS Titer, S No No
PC1BS PCA-1 Immunoblot, S No No
AGNTS AGNA-1 Titer, S No No
AN1TS ANNA-1 Titer, S No No
AN2TS ANNA-2 Titer, S No No
AN3TS ANNA-3 Titer, S No No
APBCS AP3B2 CBA, S No No
APBTS AP3B2 IFA Titer, S No No
APHTS Amphiphysin Ab Titer, S No No
CRMTS CRMP-5-IgG Titer, S No No
NCDCS Neurochondrin CBA, S No No
NCDTS Neurochondrin IFA Titer, S No No
PC1TS PCA-1 Titer, S No No
PC2TS PCA-2 Titer, S No No
SP7CS Septin-7 CBA, S No No
SP7TS Septin-7 IFA Titer, S No No
T46CS TRIM46 Ab CBA, S No No
T46TS TRIM46 Ab IFA Titer, S No No
MP1BS MAP1B Immunoblot, S No No
CRMWS CRMP-5-IgG Western Blot, S No No

Testing Algorithm

Results from this test can be entered into the TRUE-MOGAD calculator, a practical, weighted, point-based tool that helps distinguish myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) among patients with positive MOG-IgG testing.

 

If the indirect immunofluorescence assay (IFA) patterns suggest antiglial nuclear antibody (AGNA)-1, then the AGNA-1 immunoblot and AGNA-1 IFA titer will be performed at an additional charge.

 

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

 

If the IFA pattern suggests ANNA-2 antibodies, then the ANNA-2 IFA titer, ANNA-2 immunoblot, 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 IFA patterns suggest collapsin response-mediator protein-5 (CRMP-5)-IgG, then the CRMP-5-IgG Western blot and CRMP-5-IgG IFA titer will be performed at an additional charge.

 

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

 

If the IFA pattern suggests PCA-2 antibody, then the PCA-2 IFA titer and microtubule-associated protein 1B (MAP1B) immunoblot will be performed at an additional charge.

 

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

 

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

 

If the IFA pattern suggests metabotropic glutamate receptor 1 (mGluR1) antibody, then the mGluR1antibody CBA and mGluR1 antibody IFA titer will be performed at an additional charge.

 

If the neuromyelitis optica/aquaporin-4-IgG (NMO/AQP4-IgG) fluorescence-activated cell sorting (FACS) screen assay requires further investigation, then the NMO/AQP4-IgG FACS titration assay will be performed at an additional charge.

 

If the myelin oligodendrocyte glycoprotein (MOG) FACS screen assay requires further investigation, then the MOG FACS titration assay 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-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.

 

For more information see:

Autoimmune/Paraneoplastic Myelopathy Evaluation Algorithm-Serum

Central Nervous System Demyelinating Disease Diagnostic Algorithm

Method Name

MSI1: Technical Interpretation

AGN1S, AMPHS, ANN1S, ANN2S, ANN3S, APBIS, CRMS, GL1IS, NCDIS, PCAB2, PCABP, SP7IS, T46IS, AGNTS, AN1TS, AN2TS, AN3TS, APBTS, APHTS, CRMTS, DPPTS, GABIS, GL1TS, NCDTS, PC1TS, PC2TS, SP7TS, T46TS: Indirect Immunofluorescence Assay (IFA)

GD65S: Radioimmunoassay (RIA)

CRMWS: Western Blot (WB)

AGNBS, AMIBS, AN1BS, AN2BS, MP1BS, PC1BS: Immunoblot (IB)

MOGFS, NMOFS, MOGTS, NMOTS: Flow Cytometry

DPPCS, GABCS, APBCS, GL1CS, NCDCS, SP7CS, T46CS: Cell Binding Assay (CBA)

Reporting Name

Myelopathy, Autoimm/Paraneo, S

Specimen Type

Serum

Specimen Minimum Volume

Serum: 2 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

MSI1

Autoimmune Myelopathy Interp, S

Technical interpretation

Interpretive report

AMPHS

Amphiphysin Ab, S

IFA

Negative

AGN1S

Anti-Glial Nuclear Ab, Type 1

IFA

Negative

ANN1S

Anti-Neuronal Nuclear Ab, Type 1

IFA

Negative

ANN2S

Anti-Neuronal Nuclear Ab, Type 2

IFA

Negative

ANN3S

Anti-Neuronal Nuclear Ab, Type 3

IFA

Negative

APBIS

AP3B2 IFA, S

IFA

Negative

CRMS

CRMP-5-IgG, S

IFA

Negative

DPPCS

DPPX Ab CBA, S

CBA

Negative

GABCS

GABA-B-R Ab CBA, S

CBA

Negative

GD65S

GAD65 Ab Assay, S

RIA

≤0.02 nmol/L

GL1IS

mGluR1 Ab IFA, S

IFA

Negative

MOGFS

MOG FACS, S

FC

Negative

NCDIS

Neurochondrin IFA, S

IFA

Negative

NMOFS

NMO/AQP4 FACS, S

FC

Negative

PCABP

Purkinje Cell Cytoplasmic Ab Type 1

IFA

Negative

PCAB2

Purkinje Cell Cytoplasmic Ab Type 2

IFA

Negative

SP7IS

Septin-7 IFA, S

IFA

Negative

T46IS

TRIM46 Ab IFA, S

IFA

Negative

Reflex Information

Test ID

Reporting name

Methodology*

Reference value

AGNBS

AGNA-1 Immunoblot, S

IB

Negative

AGNTS

AGNA-1 Titer, S

IFA

<1:240

APHTS

Amphiphysin Ab Titer, S

IFA

<1:240

AMIBS

Amphiphysin Immunoblot, S

IB

Negative

AN1BS

ANNA-1 Immunoblot, S

IB

Negative

AN1TS

ANNA-1 Titer, S

IFA

<1:240

AN2BS

ANNA-2 Immunoblot, S

IB

Negative

AN2TS

ANNA-2 Titer, S

IFA

<1:240

AN3TS

ANNA-3 Titer, S

IFA

<1:240

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

GABIS

GABA-B-R Ab IF Titer Assay, S

IFA

<1:240

MP1BS

MAP1B Immunoblot, S

IB

Negative

GL1CS

mGluR1 Ab CBA, S

CBA

Negative

GL1TS

mGluR1 Ab IFA Titer, S

IFA

<1:240

MOGTS

MOG FACS Titer, S

FC

Negative

NCDCS

Neurochondrin CBA, S

CBA

Negative

NCDTS

Neurochondrin IFA Titer, S

IFA

<1:240

NMOTS

NMO/AQP4 FACS Titer, S

FC

Negative

PC1BS

PCA-1 Immunoblot, S

IB

Negative

PC1TS

PCA-1 Titer, S

IFA

<1:240

PC2TS

PCA-2 Titer, S

IFA

<1:240

SP7CS

Septin-7 CBA, S

CBA

Negative

SP7TS

Septin-7 IFA Titer, S

IFA

<1:240

T46CS

TRIM46 Ab CBA, S

CBA

Negative

T46TS

TRIM46 Ab IFA Titer, S

IFA

<1:240

 

*Methodology abbreviations:

Cell-binding assay (CBA)

 

Flow cytometry (FC)

Immunoblot (IB)

Immunofluorescence assay (IFA)

Radioimmunoassay (RIA)

Western Blot (WB)

Day(s) Performed

Profile tests: Monday through Sunday; Reflex tests: Varies

Report Available

8 to 12 days

Performing 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 15

86053

86363

86341

84182 AGNBS (if appropriate)

86256 AGNTS (if appropriate)

86256 APHTS (if appropriate)

84182 AMIBS (if appropriate)

84182 AN1BS (if appropriate)

86256 AN1TS (if appropriate)

84182 AN2BS (if appropriate)

86256 AN2TS (if appropriate)

86256 AN3TS (if appropriate)

86255 APBCS (if appropriate)

86256 APBTS (if appropriate)

86256 CRMTS (if appropriate)
84182 CRMWS (if appropriate)

86256 DPPTS (if appropriate)

86256 GABIS (if appropriate)

84182 MP1BS (if appropriate)

86255 GL1CS (if appropriate)

86256 GL1TS (if appropriate)

86363 MOGTS (if appropriate)

86255 NCDCS (if appropriate)

86256 NCDTS (if appropriate)

86053 NMOTS (if appropriate)

84182 PC1BS (if appropriate)

86256 PC1TS (if appropriate)

86256 PC2TS (if appropriate)

86255 SP7CS (if appropriate)

86256 SP7TS (if appropriate)

86255 T46CS (if appropriate)

86256 T46TS (if appropriate)

LOINC Code Information

Test ID Test Order Name Order LOINC Value
MAS1 Myelopathy, Autoimm/Paraneo, S 94339-9

 

Result ID Test Result Name Result LOINC Value
61519 GABA-B-R Ab CBA, S 93428-1
38324 NMO/AQP4 FACS, S 43638-6
65563 MOG FACS, S 90248-6
64933 DPPX Ab CBA, S 94676-4
64928 mGluR1 Ab IFA, S 94347-2
605127 Autoimmune Myelopathy Interp, S 69048-7
615867 Neurochondrin IFA, S 101452-1
615875 Septin-7 IFA, S 101465-3
615863 AP3B2 IFA, S 101907-4
616445 TRIM46 Ab IFA, S 105525-0
89080 AGNA-1, S 84927-3
81722 Amphiphysin Ab, S 72327-0
80150 ANNA-1, S 33615-6
80776 ANNA-2, S 43187-4
83137 ANNA-3, S 43102-3
83077 CRMP-5-IgG, S 72504-4
81596 GAD65 Ab Assay, S 94345-6
83138 PCA-2, S 84925-7
9477 PCA-1, S 84924-0
618904 IFA Notes 48767-8