Autoimmune Pediatric CNS Disorders, CSF
Test Mnemonic
APCNSC
CPT Codes
- 86341 - QTY (1)
- 86052 - QTY (1)
- 86255 - QTY (9)
Includes
- mGluR1 Ab IgG CBA-IFA Screen, CSF
- Glutamic Acid Decarboxylase Antibody CSF
- LGI1 Ab IgG CBA-IFA Screen, CSF
- NMDA Receptor Ab IgG CBA-IFA, CSF
- NMO/AQP4 Ab IgG CBA-IFA Screen, CSF
- CASPR2 Ab IgG CBA-IFA Screen, CSF
- GABA-BR Ab IgG CBA-IFA Screen, CSF
- DPPX Ab IgG CBA-IFA Screen, CSF
- GABA-AR Ab IgG CBA-IFA Screen, CSF
- Paraneoplastic Abs (PCCA/ANNA) IgG, CSF
- AMPA Receptor Ab IgG CBA-IFA Screen, CSF
Performing Laboratory
ARUP
Specimen Requirements
| Volume | Type | Container | Collect Temperature | Transport Temperature | Special Instructions |
|---|---|---|---|---|---|
| 4 mL | Cerebrospinal fluid (CSF) | Sterile container | Frozen | Transfer 4 mL CSF to a standard aliquot tube and freeze. |
Minimum Specimen Requirements
| Volume | Type | Container | Collect Temperature | Transport Temperature | Special Instructions |
|---|---|---|---|---|---|
| 2 mL |
Stability
| Environmental Condition | Description |
|---|---|
| Frozen | 30 days (avoid repeated freeze/thaw cycles) |
| Refrigerated | 1 week |
| Ambient | 24 hours |
Days Performed
Varies
Turnaround Time
4 - 11 days
Methodology
| Name | Description |
|---|---|
| Enzyme-Linked Immunosorbent Assay (ELISA) | |
| Semi-Quantitative Cell-Based Indirect Fluorescent Antibody | |
| Semi-Quantitative Indirect Fluorescent Antibody |
Special Info
Reflex Algorithm: Each reflex test performed incurs additional charge. If NMDA CSF antibody IgG is positive, then titer will be performed. PCCA/ANNA antibody IgG is screened by IFA. If the IFA screen is indeterminate, then a Neuronal Nuclear Antibodies (Hu andTr/DNER) IgG by Immunoblot will be performed. If the IFA screen is positive at 1:10 or greater, then a PCCA/ANNA antibodies titer and Neuronal Nuclear Antibodies (Hu and Tr/DNER) IgG by Immunoblot will be performed. If LGI1 CSF antibody IgG is positive, then titer will be added. If CASPR2 CSF antibody IgG is positive, then titer will be added. If AQP4/NMO CSF antibody IgG by IFA is positive, then titer will be added. If GABA-BR CSF antibody IgG by IFA is positive, then titer will be added. If DPPX CSF antibody IgG by IFA is positive, then titer will be added. If mGluR1 CSF antibody IgG by IFA is positive, then titer will be added. If GABA-AR CSF antibody IgG by IFA is positive, then titer will be added. If AMPA CSF antibody is positive, then titer will be added. Grossly hemolyzed specimens will be rejected. This test is New York state approved.
Clinical Info
Use to evaluate subacute-onset encephalopathy, epilepsy, behavior changes, or movement disorders in individuals <18 years of age.
Reflex Tests
The following additional test(s) may be ordered depending on results: