Dysautonomia, Autoimmune/Paraneoplastic Evaluation, Serum

OVERVIEW

The Dysautonomia, Autoimm/Paraneo, S test panel uses various assays, including indirect immunofluorescence assay (IFA), cell-binding assay (CBA), immunoblot (IB), and radioimmunoassay (RIA), to detect autoantibodies related to dysautonomia and paraneoplastic neurological disorders. If indicated by IFA patterns, additional tests like IFA titers and Western blot are performed for specific antibodies such as CRMP-5-IgG, ANNA-1, AP3B2, DPPX, and PCA-2, which incur extra charges. These autoantibodies include ANNA, CRMP-5, DPPX, and PCA-2, signaling specific neurological conditions. The preferred specimen is serum, collected in red-top tubes, with 4 mL required. Collection involves centrifugation and aliquoting serum into a plastic vial.

TESTING ALGORITHM

If the indirect immunofluorescence assay (IFA) patterns suggest collapsin response-mediator protein (CRMP)-5-IgG, then 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 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 AP3B2 cell-binding assay (CBA) and AP3B2 IFA titer will be performed at an additional charge.

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

If the IFA pattern suggests Purkinje cytoplasmic antibody type 2 (PCA-2), then PCA-2 titer is performed at an additional charge.

METHOD NAME

ANN1S, AN1TS, APBIS, APBTS, DPPIS, DPPTS, PCAB2, PC2TS, CRMS, CRMTS: Indirect Immunofluorescence Assay (IFA)

APBCS, CS2CS, DPPCS, LG1CS: Cell Binding Assay (CBA)

CRMWS: Western Blot (WB)

AN1BS, AN2BS: Immunoblot (IB)

GANG: Radioimmunoassay (RIA)

AVAILABILITY

TBC

REPORTING NAME

Dysautonomia, Autoimm/Paraneo, S

ALIASES

ANNA (Antineuronal Nuclear Antibody)

Anti-CV2

Anti-Enteric Neuronal Antibody

Anti-Hu

Antineuronal

Cerebellar Antibodies

Chorea

Collapsin Response-Mediator Protein-5 Antibody (CRMP-5), Serum

Cramp-fasciculation

CRMP-5, IgG

Dorsal Root Ganglion Antibody

DPPX

Hu Antibody

Isaacs disease

Motor End-Plate Antibody

Motor Nerve Terminal Antibodies

Myoid Antibody

Neuromuscular hyperexcitability

Neuromyotonia

Neuronal ganglionic acetylcholine receptor antibody

Neuronal Nuclear Antibody Panel

Neuronal-Anti

Paraneoplastic Antibodies

Paraneoplastic Autoantibody Evaluation

Paraneoplastic Neurological Autoimmunity

Dipeptidyl aminopeptidase-like protein 6

SPECIMEN TYPE 

Serum

SHIPPING INSTRUCTIONS

TBC

SPECIMEN REQUIRED

Patient preparation:

1. To enhance antibody detection accuracy, it is advised to collect specimens before the initiation of immunosuppressant medication or intravenous immunoglobulin treatment.

2. This test should not be requested for patients who have recently undergone radioisotope therapy or diagnostic procedures, as it may lead to potential interference with the assay. The specific waiting period before specimen collection will vary based on factors such as the administered isotope, dosage, and individual patient clearance rate. Specimens will undergo radioactivity screening prior to analysis. Radioactive specimens received in the laboratory will be held for one week and assayed only if sufficiently decayed, or canceled if radioactivity persists.

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

Collection Instructions: Centrifuge and aliquot serum into a plastic vial.