|Values are valid only on day of printing.|
Indirect Immunofluorescence Assay (IFA):
IFA for neuronal nuclear and cytoplasmic autoantibodies. Patient's serum is preabsorbed with liver powder to remove nonorgan-specific autoantibodies before applying a composite substrate of frozen mouse tissues (brain, kidney, and gut). After washing, fluorescein-conjugated goat antihuman IgG is applied to detect the distribution and pattern of the patient's bound IgG.(Pittock SJ, Kryzer TJ, Lennon VA: Paraneoplastic antibodies coexist and predict cancer, not neurological syndrome. Ann Neurol 2004;56:715-719; Yu Z, Kryzer TJ, Griesmann GE, et al: CRMP-5 neuronal autoantibody: marker of lung cancer and thymoma-related autoimmunity. Ann Neurol 2001;49:146-154; Pittock SJ, Yoshikawa H, Ahlskog JE, et al: Glutamic acid decarboxylase autoimmunity with brainstem, extrapyramidal and spinal cord dysfunction. Mayo Clin Proc 2006;81:1207-1214)
Goat antihuman IgG and IgM is used as precipitant in all assays. Iodine-labelled recombinant human glutamic acid decarboxylase (GAD65) is used as antigen to confirm GAD65 autoantibody.(Walikonis JE, Lennon VA: Radioimmunoassay for glutamic acid decarboxylase [GAD65] autoantibodies as a diagnostic aid for stiff-man syndrome and a correlate of susceptibility to type 1 diabetes mellitus. Mayo Clin Proc 1998;73:1161-1166)
Cation channel protein antigens are solubilized from neuronal or muscle membranes, in nonionic detergent and complexed with a selective high-affinity ligand that is labeled with (125)I.(Griesmann GE, Kryzer TJ, Lennon VA: Autoantibody profiles of myasthenia gravis and Lambert-Eaton Myasthenic syndrome. In Manual of Clinical and Laboratory Immunology. Sixth edition. Edited by NR Rose, RG Hamilton, et al. Washington, DC, ASM Press 2002, pp 1005-1012)
Enzyme Immunoassay (EIA):
A mixture of sarcomeric proteins extracted from innervated rat skeletal muscle is used as antigen to detect striational antibodies (IgG, IgM, and IgA).(Cikes N, Momoi MY, Williams CL, et al: Striational autoantibodies: quantitative detection by enzyme immunoassay in myasthenia gravis, thymoma, and recipients of D-penicillamine or allogeneic bone marrow. Mayo Clin Proc 1988;63:474-481)
Western Blot (WB):
The antigen is full-length recombinant human CRMP-5.(Yu Z, Kryzer TJ, Griesmann GE, et al: CRMP-5 neuronal autoantibody: marker of lung cancer and thymoma-related autoimmunity. Ann Neurol 2001;49:145-154)
Cell Binding Assay (CBA):
Patient serum is applied to a composite slide containing transfected and nontransfected HEK-293 cells. After incubation and washing, fluorescein-conjugated goat antihuman IgG is applied to detect the presence of patient IgG binding.(Package insert: EUROIMMUN AG. Stocker W, et al. Differenzierte Autoantikorper-Diagnostik mit BIOCHIP-Mosaiken. U Conrad, K. (Hrsg) Autoantikorper. Pabst-Verlag  78-99)
ANNA-1, ANN2S, ANN3S, PCABP, PCAB2, PCATR, AMPHS, CRMS, AGN1S, NMDIS, AMPIS, GABIS: Monday through Thursday, Sunday; 12 p.m. and 5 p.m.
Striational (striated muscle) antibodies: Monday through Friday; 2 p.m.
N-type calcium channel antibody: Monday through Friday; 6 a.m.
Acetylcholine receptor (muscle AChR) binding antibody: Monday through Friday, Sunday; 2 p.m.
Ganglionic acetylcholine receptor (alpha3) autoantibody: Sunday through Thursday; 10 p.m.
Neuronal (VGKC) autoantibody: Sunday through Thursday; 10 p.m.
GAD65 antibody assay: Monday through Friday; 2 a.m.
Paraneoplastic autoantibody Western blot: Monday through Friday; 8 a.m.
Acetylcholine receptor (muscle) modulating antibodies: Monday through Thursday, Saturday; 12 p.m.
CRMP-5-IgG Western blot: Monday through Friday; 8 a.m.
Amphiphysin Western blot: Monday through Friday; 8 a.m.
NMO/AQP4-IgG CBA, NMDCS, AMPCS, GABCS: Monday through Friday; 4 a.m.