Laboratory Test Information Guide

	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 against	Associated Neurological Disorders	Frequently Associated Tumors
NMDAR	Anti-NMDAR encephalitis	Ovarian teratoma, testicular teratoma
LGI1	Limbic encephalitis	Thyroid carcinoma, small cell lung cancer, kidney cell carcinoma, ovarian teratoma, thymoma
CASPR2	Neuromyotonia, Morvan’s syndrome, Limbic encephalitis	Thymoma
AMPAR1/R2	Limbic encephalitis	Bronchial carcinoma, breast carcinoma, thymoma
GABAB1/B2	Limbic encephalitis	Small cell lung cancer
DPPX	Anti-DPPX associated autoimmune encephalitis
Hu (ANNA-1)	Paraneoplastic encephalomyelitis	Small cell lung cancer, neuroblastoma
Yo (PCA-1)	Paraneoplastic cerebellar degeneration	Ovarian cancer, breast cancer, uterine carcinoma
Ri (ANNA-2)	Paraneoplastic opsoclonus myoclonus ataxia	Neuroblastoma, Breast cancer
Ma2/Ta	Rhombencephalitis, paraneoplastic limbic encephalitis, brain stem encephalopathy	Germinal carcinoma of the testis (seminoma)
Amphiphysin	Stiff-person syndrome, Myasthenic syndrome	Breast cancer, small cell lung cancer
CV2 (CRMP5)	Limbic encephalitis	Small cell lung cancer, thymoma
Recoverin	Retinopathy	Small cell lung cancer
SOX1	Lambert-Eaton myasthenic syndrome	Small cell lung cancer
Titin	Myasthenia gravis	Thymoma
Anti-Zic4	Paraneoplastic cerebellar degeneration	Small cell lung cancer
Tr (DNER)	Paraneoplastic cerebellar degeneration	Hodgkin‘s lymphoma
GAD65	Stiff-person syndrome	Small 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 4^oC. For longer storage, store at -20^oC.
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