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Test ID: ENCES    
Encephalopathy, Autoimmune Evaluation, Serum

Testing Algorithm Delineates situation(s) when tests are added to the initial order. This includes reflex and additional tests.

If indirect immunofluorescence assay (IFA) suggests ANN1S, ANN2S, ANN3S, PCAB2, PCATR, AMPHS, CRMS, or AGN1S is indeterminate, then paraneoplastic autoantibody Western blot is performed at an additional charge.

If client requests, or if IFA patterns suggests CRMP-5-IgG, then CRMP-5-IgG Western blot is performed at an additional charge.

If IFA patterns suggest amphiphysin antibody, then amphiphysin Western blot is performed at an additional charge.

If IFA pattern suggest NMO/AQP4-IgG, then NMO/AQP4-IgG CBA is performed at an additional charge.

If IFA pattern suggest NMDA-R antibody and NMDA-R antibody CBA is positive, then NMDA-R titer is performed at an additional charge.

If IFA pattern suggest AMPA-R antibody and AMPA-R antibody CBA is positive, then AMPA-R titer is performed at an additional charge.

If IFA pattern suggest GABA-B-R antibody and GABA-B-R antibody CBA is positive, then GABA-B-R titer is performed at an additional charge.

 

Western Blot:

Native neuronal antigens: performed to confirm neuronal nuclear and cytoplasmic antibody specificities when IF screening is uninterpretable.

Recombinant human collapsin response-mediator protein‑5: performed to confirm CRMP-5-IgG when IF screening is uninterpretable. Also performed for more sensitive detection of CRMP-5-IgG.

 

RIA:

Confirmation of GAD65 antibodies when IF screening suggests GAD65 antibodies.

 

See Encephalopathy Autoimmune Evaluation Algorithm, Serum in Special Instructions

Specimen Type Describes the specimen type needed for testing

Serum

Specimen Required Defines the optimal specimen. This field describes the type of specimen required to perform the test and the preferred volume to complete testing. The volume allows automated processing, fastest throughput and, when indicated, repeat or reflex testing.

Container/Tube:

Preferred: Red top

Acceptable: Serum gel

Specimen Volume: 4 mL

Additional Information: Include relevant clinical information, name, phone number, mailing address, and e-mail address (if applicable) of ordering physician.

Forms: If not ordering electronically, complete, print, and send a Neurology Test Request Form (T732) with the specimen (http://www.mayomedicallaboratories.com/it-mmfiles/neurology-request-form.pdf)

Specimen Minimum Volume Defines the amount of specimen required to perform an assay once, including instrument and container dead space. Submitting the minimum specimen volume makes it impossible to repeat the test or perform confirmatory or perform reflex testing. In some situations, a minimum specimen volume may result in a QNS (quantity not sufficient) result, requiring a second specimen to be collected.

2 mL

Reject Due To Identifies specimen types and conditions that may cause the specimen to be rejected

Hemolysis

Mild OK; Gross reject

Lipemia

Mild OK; Gross OK

Icterus

NA

Other

NA

Specimen Stability Information Provides a description of the temperatures required to transport a specimen to the laboratory. Alternate acceptable temperature(s) are also included.

Specimen TypeTemperatureTime
SerumRefrigerated (preferred)28 days
 Frozen 28 days
 Ambient 72 hours

Key