ENS1 - Overview: Encephalopathy, Autoimmune Evaluation, Serum

Test Catalog

Test Name

Test ID: ENS1    
Encephalopathy, Autoimmune Evaluation, Serum

Useful For Suggests clinical disorders or settings where the test may be helpful

Evaluating new onset encephalopathy (noninfectious or metabolic) comprising confusional states, psychosis, delirium, memory loss, hallucinations, movement disorders, sensory or motor complaints, seizures, dyssomnias, ataxias, nausea, vomiting, inappropriate antidiuresis, coma, dysautonomias, or hypoventilation in serum specimens

 

The following accompaniments should increase of suspicion for autoimmune encephalopathy:

-Headache

-Autoimmune stigmata (personal or family history or signs of diabetes mellitus, thyroid disorder, vitiligo, poliosis [premature graying], myasthenia gravis, rheumatoid arthritis, systemic lupus erythematosus)

-History of cancer

-Smoking history (20+ pack years) or other cancer risk factors

-Inflammatory cerebral spinal fluid (or isolated protein elevation)

-Neuroimaging signs suggesting inflammation

 

Evaluating limbic encephalitis (noninfectious)

 

Directing a focused search for cancer

 

Investigating encephalopathy appearing in the course or wake of cancer therapy and not explainable by metastasis or drug effect

Profile Information A profile is a group of laboratory tests that are ordered and performed together under a single Mayo Test ID. Profile information lists the test performed, inclusive of the test fee, when a profile is ordered and includes reporting names and individual availability.

Test IDReporting NameAvailable SeparatelyAlways Performed
AEESIEncephalopathy, Interpretation, SNoYes
NMDCSNMDA-R Ab CBA, SNoYes
VGKCNeuronal (V-G) K+ Channel Ab, SNoYes
LG1CSLGI1-IgG CBA, SNoYes
CS2CSCASPR2-IgG CBA, SNoYes
GD65SGAD65 Ab Assay, SYesYes
GABCSGABA-B-R Ab CBA, SNoYes
AMPCSAMPA-R Ab CBA, SNoYes
ANN1SAnti-Neuronal Nuclear Ab, Type 1NoYes
ANN2SAnti-Neuronal Nuclear Ab, Type 2NoYes
ANN3SAnti-Neuronal Nuclear Ab, Type 3NoYes
AGN1SAnti-Glial Nuclear Ab, Type 1NoYes
PCABPPurkinje Cell Cytoplasmic Ab Type 1NoYes
PCAB2Purkinje Cell Cytoplasmic Ab Type 2NoYes
PCATRPurkinje Cell Cytoplasmic Ab Type TrNoYes
AMPHSAmphiphysin Ab, SNoYes
CCNN-Type Calcium Channel AbNoYes
CCPQP/Q-Type Calcium Channel AbNoYes
ARBIACh Receptor (Muscle) Binding AbNoYes
GANGAChR Ganglionic Neuronal Ab, SNoYes
CRMSCRMP-5-IgG, SNoYes

Reflex Tests Lists test(s) that may or may not be performed, at an additional charge, depending on the result and interpretation of the initial test(s)

Test IDReporting NameAvailable SeparatelyAlways Performed
WBNParaneoplastic Autoantibody WBlot,SNoNo
CRMWSCRMP-5-IgG Western Blot, SYesNo
ABLOTAmphiphysin Western Blot, SNoNo
NMOFSNMO/AQP4 FACS, SYesNo
NMOTSNMO/AQP4 FACS Titer, SNoNo
AMPISAMPA-R Ab IF Titer Assay, SNoNo
GABISGABA-B-R Ab IF Titer Assay, SNoNo
NMDISNMDA-R Ab IF Titer Assay, SNoNo

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 FACS is performed at an additional charge.

 

If NMO/AQP4-IgG FACS screen assay requires further investigation, then NMO/AQP4-IgG FACS titration assay 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

Special Instructions and Forms Describes specimen collection and preparation information, test algorithms, and other information pertinent to test. Also includes pertinent information and consent forms to be used when requesting a particular test

Method Name A short description of the method used to perform the test

ANN1S, ANN2S, ANN3S, AGN1S, PCAB2, PCATR, AMPHS, CRMS, PCABP, NMDIS, AMPIS, GABIS: Indirect Immunofluorescence Assay (IFA)

VGKC, CCN, CCPQ, GANG, GD65S, ARBI: Radioimmunoassay (RIA)

WBN, ABLOT: Western Blot

AMPCS, GABCS, NMDCS, LG1CS, CS2CS: Cell Binding Assay (CBA)

NY State Approved Indicates the status of NY State approval and if the test is orderable for NY State clients.

Yes

Reporting Name A shorter/abbreviated version of the Published Name for a test; an abbreviated test name

Encephalopathy-Autoimmune Eval, S

Aliases Lists additional common names for a test, as an aid in searching

ACh Receptor (Muscle) Binding Ab
AChR Ganglionic Ab
AMPA-R Ab CBA
Amphiphysin Ab
Anti-Glial Nuclear Ab, Type 1
Anti-Neuronal Nuclear Ab, Type 1
Anti-Neuronal Nuclear Ab, Type 2
Anti-Neuronal Nuclear Ab, Type 3
Behavioral change
Confusion
CRMP-5-IgG
Encephalitis
ENCES_x
GABA-B-R Ab CBA
Glutamic Acid Decarboxylase (GAD65)
N-type Voltage-Gated Calcium Channel Ab
Neuronal (V-G) K+ Channel Ab
NMDA-R Ab CBA
P/Q-type Voltage-Gated Calcium Channel Ab
Psychosis
Purkinje Cell Cytoplasmc Ab Type Tr
Purkinje Cell Cytoplasmic Ab Type 1
Purkinje Cell Cytoplasmic Ab Type 2
LGI1-IgG
CASPR2-IgG
Contactin-Associated Protein-Like-2 (CASPR2)-IgG
Leucine-Rich Glioma Inactived Protein-1 IgG