Encephalopathy, Autoimmune Evaluation, CSF
Test Code: ENCEC
CPT Code: 83519 001 86255 014 86341 001
Specimen Container
4 mL Spinal Fluid
Minimum Collection Volume
2 mL Spinal Fluid
Specimen Handling
include any relevant clinical information.
Unacceptable Conditions
Grossly hemolyzed specimens
Grossly lipemic specimens
Grossly lipemic specimens
Methodology
Indirect Immunofluorescence Assay (IFA); Cell-Binding Assay (CBA); Immunoprecipitation Assay; Radioimmunoassay (RIA); Western Blot
Stability
Ambient: 3 days Refrigerated: 28 days Frozen: 28 days
Test Includes
Components
Encephalopathy, Interpretation, CSF
NMDA-R Ab CBA, CSF
VGKC-complex Ab IPA, CSF
LGI1-IgG CBA, CSF
CASPR2-IgG CBA, CSF
GAD65 Ab Assay, CSF
GABA-B-R Ab CBA, CSF
AMPA-R Ab CBA, CSF
Anti-Neuronal Nuclear Ab, Type 1
Anti-Neuronal Nuclear Ab, Type 2
Anti-Neuronal Nuclear Ab, Type 3
Anti-Glial Nuclear Ab, Type 1
Purkinje Cell Cytoplasmic Ab Type 1
Purkinje Cell Cytoplasmic Ab Type 2
Purkinje Cell Cytoplasmc Ab Type Tr
Amphiphysin Ab, CSF
CRMP-5-IgG, CSF
Reflex Tests:
Paraneoplas Autoantibody WBlot, CSF
CRMP-5-IgG Western Blot, CSF
Amphiphysin Western Blot, CSF
NMO/AQP4 FACS, CSF
NMO/AQP4 FACS Titer, CSF
AMPA-R Ab IF Titer Assay, CSF
GABA-B-R Ab IF Titer Assay, CSF
NMDA-R Ab IF Titer Assay, CSF
Encephalopathy, Interpretation, CSF
NMDA-R Ab CBA, CSF
VGKC-complex Ab IPA, CSF
LGI1-IgG CBA, CSF
CASPR2-IgG CBA, CSF
GAD65 Ab Assay, CSF
GABA-B-R Ab CBA, CSF
AMPA-R Ab CBA, CSF
Anti-Neuronal Nuclear Ab, Type 1
Anti-Neuronal Nuclear Ab, Type 2
Anti-Neuronal Nuclear Ab, Type 3
Anti-Glial Nuclear Ab, Type 1
Purkinje Cell Cytoplasmic Ab Type 1
Purkinje Cell Cytoplasmic Ab Type 2
Purkinje Cell Cytoplasmc Ab Type Tr
Amphiphysin Ab, CSF
CRMP-5-IgG, CSF
Reflex Tests:
Paraneoplas Autoantibody WBlot, CSF
CRMP-5-IgG Western Blot, CSF
Amphiphysin Western Blot, CSF
NMO/AQP4 FACS, CSF
NMO/AQP4 FACS Titer, CSF
AMPA-R Ab IF Titer Assay, CSF
GABA-B-R Ab IF Titer Assay, CSF
NMDA-R Ab IF Titer Assay, CSF
Reference Range Information
NEURONAL NUCLEAR ANTIBODIES
Antineuronal Nuclear Antibody-Type 1 (ANNA-1). . . . . . . . . . . . . . . . . <1:2
Antineuronal Nuclear Antibody-Type 2 (ANNA-2) . . . . . . . . . . . . . . . . .<1:2
Antineuronal Nuclear Antibody-Type 3 (ANNA-3). . . . . . . . . . . . . . . . . <1:2
Anti-Glial/Neuronal Nuclear Antibody-Type 1 (AGNA-1). . . . . . . . . . . . <1:2
NEURONAL AND MUSCLE CYTOPLASMIC ANTIBODIES
Purkinje Cell Cytoplasmic Antibody, Type 1 (PCA-1). . . . . . . . . . . . . . .<1:2
Purkinje Cell Cytoplasmic Antibody, Type 2 (PCA-2). . . . . . . . . . . . . . .<1:2
Purkinje Cell Cytoplasmic Antibody, Type TR (PCA-TR). . . . . . . . . . . .<1:2
Amphiphysin Antibody. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . <1:2
Collapsin Response-Mediator Protein-5 Neuronal (CRMP-5-IGG). . . . <1:2
ISLET CELL ANTIBODIES
Glutamic Acid Decarboxylase (GAD65) Antibody Assay. . . . . . .< or =0.02 nmol/L
AMPA-RECEPTOR ANTIBODY BY CBA
CBA. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Negative
IFA. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . <1:2
GABA-B-RECEPTOR ANTIBODY BY CBA
CBA. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Negative
IFA. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . <1:2
NMDA-RECEPTOR ANTIBODY BY CBA
CBA. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Negative
IFA. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . <1:2
LGI1-IgG CBA. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Negative
CASPR2-IgG CBA. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Negative
Neuronal Voltage-Gated Potassium Channel-Complex Autoantibody. . . . . . . .< or =0.02 nmol/L
WESTERN BLOT
Paraneoplastic Autoantibody, Western Blot Confirmation . . . . . . . . . . . . . . . . . . . Negative
Collapsin Response-Mediator Protein-5-IGG (CRMP-5-IGG) Western Blot.. .. . . . .Negative
Amphiphysin Antibody Western Blot. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Negative
Neuromyelitis Optica (NMO)/Aquaporin-4-Igg FACS Assay. . . . . . . . . . . . . . . . . . . . . Negative
Antineuronal Nuclear Antibody-Type 1 (ANNA-1). . . . . . . . . . . . . . . . . <1:2
Antineuronal Nuclear Antibody-Type 2 (ANNA-2) . . . . . . . . . . . . . . . . .<1:2
Antineuronal Nuclear Antibody-Type 3 (ANNA-3). . . . . . . . . . . . . . . . . <1:2
Anti-Glial/Neuronal Nuclear Antibody-Type 1 (AGNA-1). . . . . . . . . . . . <1:2
NEURONAL AND MUSCLE CYTOPLASMIC ANTIBODIES
Purkinje Cell Cytoplasmic Antibody, Type 1 (PCA-1). . . . . . . . . . . . . . .<1:2
Purkinje Cell Cytoplasmic Antibody, Type 2 (PCA-2). . . . . . . . . . . . . . .<1:2
Purkinje Cell Cytoplasmic Antibody, Type TR (PCA-TR). . . . . . . . . . . .<1:2
Amphiphysin Antibody. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . <1:2
Collapsin Response-Mediator Protein-5 Neuronal (CRMP-5-IGG). . . . <1:2
ISLET CELL ANTIBODIES
Glutamic Acid Decarboxylase (GAD65) Antibody Assay. . . . . . .< or =0.02 nmol/L
AMPA-RECEPTOR ANTIBODY BY CBA
CBA. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Negative
IFA. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . <1:2
GABA-B-RECEPTOR ANTIBODY BY CBA
CBA. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Negative
IFA. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . <1:2
NMDA-RECEPTOR ANTIBODY BY CBA
CBA. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Negative
IFA. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . <1:2
LGI1-IgG CBA. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Negative
CASPR2-IgG CBA. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Negative
Neuronal Voltage-Gated Potassium Channel-Complex Autoantibody. . . . . . . .< or =0.02 nmol/L
WESTERN BLOT
Paraneoplastic Autoantibody, Western Blot Confirmation . . . . . . . . . . . . . . . . . . . Negative
Collapsin Response-Mediator Protein-5-IGG (CRMP-5-IGG) Western Blot.. .. . . . .Negative
Amphiphysin Antibody Western Blot. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Negative
Neuromyelitis Optica (NMO)/Aquaporin-4-Igg FACS Assay. . . . . . . . . . . . . . . . . . . . . Negative
Schedule
Testing performed by:Mayo Clinic
Varies, based upon components and reflex testing.
Varies, based upon components and reflex testing.
Department
Referral Testing
Clinical Significance
Mayo test EPIEC is comprehensive and designed to improve patient care by providing serological testing in a cost-conscious, algorithmic approach based on the experience of Mayo Clinic physicians and scientists. Four classes of antibodies are recognized in the initial assessment: neuronal nuclear, anti-glial/neuronal nuclear, neuronal and muscle cytoplasmic, and plasma membrane cation channel. A total of 13 autoantibodies are performed in the initial panel. Dependent on the initial test results, reflex tests may be added for an additional charge. Selective antibody testing is not advised because no single neural antibody is definitively associated with a particular patient phenotype and markers of occult cancer may be missed. For more comprehensive testing, Mayo Medical Laboratories recommends submitting Serum in addition to CSF and ordering the ENCES in conjunction with the ENCEC testing. Additional information regarding testing and results is available at :
www.mayomedicallaboratories.com/test-catalog
www.mayomedicallaboratories.com/test-catalog
Additional Information
For more comprehensive testing, Mayo Medical Laboratories recommends submitting Serum in addition to CSF and ordering the ENCES in conjunction with the ENCEC testing.
If not ordering electronically, complete, print, and send a Neurology Specialty Testing Client Test Request (T732) with the specimen (http://www.mayomedicallaboratories.com/it-mmfiles/neurology-request-form.pdf).
If not ordering electronically, complete, print, and send a Neurology Specialty Testing Client Test Request (T732) with the specimen (http://www.mayomedicallaboratories.com/it-mmfiles/neurology-request-form.pdf).
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