Laboratory Test Information Guide

Details for Comprehensive Autoimmune Encephalitis Panel, Serum/CSF

Test Name: Comprehensive Autoimmune Encephalitis Panel, Serum/CSF
Alternate Name(s): Panel includes:
Autoimmune Encephalitis Antibodies
Anti-NMDAR
Anti-LGI1
Anti-CASPR2
Anti-AMPAR1/R2
Anti-GABARB1/B2
Anti-DPPX


Paraneoplastic Antibodies
Anti-Hu (ANNA-1)
Anti-Ri (ANNA-2)
Anti-Yo (PCA-1)
Anti-Amphiphysin
Anti-CV2 (CRMP5)
Anti-Ma2/Ta (PNMA2)
Anti-Tr (DNER)
Anti-Zic4
Anti-Recoverin
Anti-Titin
Anti-SOX1

Other Antibody
Anti-GAD65

Anti-GFAP
Anti-mGluR1
Anti-NIF
Anti-Neurochondrin
ANNA-3
PCA-2/Anti-MAP1B
Anti-AP3B2
Anti-PDE10A
Anti-KLHL11
Anti-ITPR1
Anti-GRAF
Laboratory: Clinical Immunology
Specimen Type: Adult:
5 mL Gold or 6 mL Red top Vacutainer tube

Pediatric:
0-2 years: 0.5 mL Red Microtainer
2-10 years: 2 mL Red top Vacutainer tube

CSF sample: Suggest CSF be submitted with serum for testing.
Collection Information: Volume required for testing is 2.0 mL
Minimum volume is 1.0 mL
Requisition: CLINICAL IMMUNOLOGY REQUISITION
Test Schedule: Batch analysis
Turnaround time from when specimen
is received in testing laboratory:
 
Routine
5 days
Stat
N/A
 
Reference Range: Negative
Effective Date: 2019-02-26
Revised Date: 2020-10-01
Critical Value:  
Interpretive Comments: 
Antibodies againstAssociated Neurological DisordersFrequently Associated Tumors
NMDARAnti-NMDAR encephalitisOvarian teratoma, testicular teratoma
LGI1Limbic encephalitisThyroid carcinoma, small cell lung cancer, kidney cell carcinoma,
ovarian teratoma, thymoma
CASPR2Neuromyotonia, Morvan’s syndrome, Limbic encephalitisThymoma
AMPAR1/R2Limbic encephalitisBronchial carcinoma, breast carcinoma, thymoma
GABAB1/B2Limbic encephalitisSmall cell lung cancer
DPPXAnti-DPPX associated autoimmune
encephalitis
Hu (ANNA-1)Paraneoplastic encephalomyelitisSmall cell lung cancer, neuroblastoma
Yo (PCA-1)Paraneoplastic cerebellar degenerationOvarian cancer, breast cancer, uterine
carcinoma
Ri (ANNA-2)Paraneoplastic opsoclonus myoclonus ataxiaNeuroblastoma, Breast cancer
Ma2/TaRhombencephalitis, paraneoplastic limbic encephalitis, brain stem encephalopathyGerminal carcinoma of the
testis (seminoma)
AmphiphysinStiff-person syndrome, Myasthenic syndromeBreast cancer, small cell lung cancer
CV2 (CRMP5)Limbic encephalitisSmall cell lung cancer, thymoma
RecoverinRetinopathySmall cell lung cancer
SOX1Lambert-Eaton myasthenic syndromeSmall cell lung cancer
TitinMyasthenia gravisThymoma
Anti-Zic4Paraneoplastic cerebellar degenerationSmall cell lung cancer
Tr (DNER)Paraneoplastic cerebellar degenerationHodgkin‘s lymphoma
GAD65Stiff-person syndromeSmall cell lung cancer
Special Processing:  
Comments: This test is available to neurologists at LHSC/SJHC and accepted from referred in locations.
A single autoantibody test is not diagnostic and should not be used to determine course of treatment.
The test result must be evaluated with consideration of clinical presentation, patient history and other laboratory tests.
Method of Analysis: Cell-based assay (CBA) and tissue indirect immunofluorescence (TIIF) assay for autoimmune encephalitis antibodies (reported based on CBA).

Immunoblot and tissue indirect immunofluorescence (TIIF) assay for paraneoplastic antibodies (reported based on immunoblot).

ELISA and immunoblot for Anti-GAD65.

Each sample will also be screened for the following neural antibodies based on research use-only TIIF, only negative reported on a research basis.
Anti-GFAP
Anti-mGluR1
Anti-NIF
Anti-Neurochondrin
ANNA-3
PCA-2/Anti-MAP1B
Anti-AP3B2
Anti-PDE10A
Anti-KLHL11
Anti-ITPR1
Anti-GRAF
Critical Information Required: Each sample must be submitted with a clinical questionnaire completed by the treating physician, which should take no more than 10-15 minutes to complete.

Clinical Questionnaire
Dr. Adrian Budhram will review the provided clinical information for every positive neural antibody result, and contact the ordering physician to promptly review the result and aid in clinical-serological correlation.
Storage & Shipment: Sample can be stored for up to 14 days at 4oC. For longer storage, store at -20oC.
Send samples together with a completely filled out questionnaire.
System Codes: 
Cerner
AEPS for serum; AEPCSF for CSF
 
Referred To:  

Questions? Comments? Contact Laura Gopaul