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HelpTest Code DMS2 Dementia, Autoimmune Evaluation, Serum
Necessary Information
Provide the following information:
-Relevant clinical information
-Ordering provider name, phone number, mailing address, and e-mail address
Specimen Required
Patient Preparation:
1. For optimal antibody detection, specimen collection is recommended prior to initiation of immunosuppressant medication.
2. This test should not be requested in patients who have recently received radioisotopes, therapeutically or diagnostically, because of potential assay interference. The specific waiting period before specimen collection will depend on the isotope administered, the dose given, and the clearance rate in the individual patient. Specimens will be screened for radioactivity prior to analysis. Radioactive specimens received in the laboratory will be held 1 week and assayed if sufficiently decayed, or canceled if radioactivity remains.
3. Patient should have no general anesthetic or muscle-relaxant drugs in the previous 24 hours.
Container/Tube:
Preferred: Red top
Acceptable: Serum gel
Specimen Volume: 4 mL
Forms
If not ordering electronically, complete, print, and send a Neurology Specialty Testing Client Test Request (T732) with the specimen.
Useful For
Investigating new onset dementia and cognitive impairment plus 1 or more of the following using serum specimens:
-Rapid onset and progression
-Fluctuating course
-Psychiatric accompaniments (psychosis, hallucinations)
-Movement disorder (myoclonus, tremor, dyskinesias)
-Headache
-Autoimmune stigmata (personal history or family history or signs of diabetes mellitus, thyroid disorder, vitiligo, poliosis [premature graying], myasthenia gravis, rheumatoid arthritis, systemic lupus erythematosus)
-Smoking history (20+ pack years) or other cancer risk factors
-History of cancer
-Inflammatory cerebrospinal fluid
-Neuroimaging findings atypical for degenerative etiology
Profile Information
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| ADMSI | Dementia, Interpretation, S | No | Yes |
| GANG | AChR Ganglionic Neuronal Ab, S | No | Yes |
| AMPCS | AMPA-R Ab CBA, S | No | Yes |
| AMPHS | Amphiphysin Ab, S | No | Yes |
| AGN1S | Anti-Glial Nuclear Ab, Type 1 | No | Yes |
| ANN1S | Anti-Neuronal Nuclear Ab, Type 1 | No | Yes |
| ANN2S | Anti-Neuronal Nuclear Ab, Type 2 | No | Yes |
| ANN3S | Anti-Neuronal Nuclear Ab, Type 3 | No | Yes |
| CS2CS | CASPR2-IgG CBA, S | No | Yes |
| CRMS | CRMP-5-IgG, S | No | Yes |
| DPPIS | DPPX Ab IFA, S | No | Yes |
| GABCS | GABA-B-R Ab CBA, S | No | Yes |
| GD65S | GAD65 Ab Assay, S | Yes | Yes |
| GFAIS | GFAP IFA, S | No | Yes |
| IG5IS | IgLON5 IFA, S | No | Yes |
| LG1CS | LGI1-IgG CBA, S | No | Yes |
| GL1IS | mGluR1 Ab IFA, S | No | Yes |
| NIFIS | NIF IFA, S | No | Yes |
| NMDCS | NMDA-R Ab CBA, S | No | Yes |
| CCN | N-Type Calcium Channel Ab | No | Yes |
| CCPQ | P/Q-Type Calcium Channel Ab | No | Yes |
| PCAB2 | Purkinje Cell Cytoplasmic Ab Type 2 | No | Yes |
| PCATR | Purkinje Cell Cytoplasmic Ab Type Tr | No | Yes |
Reflex Tests
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| ARBI | ACh Receptor (Muscle) Binding Ab | Yes | No |
| ARMO | ACh Receptor (Muscle) Modulating Ab | No | No |
| AGNBS | AGNA-1 Immunoblot, S | No | No |
| AINCS | Alpha Internexin CBA, S | No | No |
| AMPIS | AMPA-R Ab IF Titer Assay, S | No | No |
| AMIBS | Amphiphysin Immunoblot, S | No | No |
| AN1BS | ANNA-1 Immunoblot, S | No | No |
| AN2BS | ANNA-2 Immunoblot, S | No | No |
| CRMWS | CRMP-5-IgG Western Blot, S | Yes | No |
| DPPCS | DPPX Ab CBA, S | No | No |
| DPPTS | DPPX Ab IFA Titer, S | No | No |
| GABIS | GABA-B-R Ab IF Titer Assay, S | No | No |
| GFACS | GFAP CBA, S | No | No |
| GFATS | GFAP IFA Titer, S | No | No |
| IG5CS | IgLON5 CBA, S | No | No |
| IG5TS | IgLON5 IFA Titer, S | No | No |
| GL1CS | mGluR1 Ab CBA, S | No | No |
| GL1TS | mGluR1 Ab IFA Titer, S | No | No |
| NFHCS | NIF Heavy Chain CBA, S | No | No |
| NIFTS | NIF IFA Titer, S | No | No |
| NFLCS | NIF Light Chain CBA, S | No | No |
| NMDIS | NMDA-R Ab IF Titer Assay, S | No | No |
| PC1BS | PCA-1 Immunoblot, S | No | No |
| PCABP | Purkinje Cell Cytoplasmic Ab Type 1 | No | No |
| PCTBS | PCA-Tr Immunoblot, S | No | No |
Testing Algorithm
If indirect immunofluorescence assay (IFA) pattern suggests AGNA-1 antibody, then AGNA-1 immunoblot is performed at an additional charge.
If IFA pattern suggests ANNA-1 antibody, then ANNA-1 immunoblot is performed at an additional charge.
If IFA pattern suggests ANNA-2 antibody, then ANNA-2 immunoblot is performed at an additional charge.
If IFA pattern suggest amphiphysin antibody, then amphiphysin immunoblot is performed at an additional charge.
If client requests or if IFA patterns suggest CRMP-5-IgG, then CRMP-5-IgG Western blot, ACh receptor (muscle) binding antibody, and ACh receptor (muscle) modulating antibody are performed at an additional charge.
If IFA pattern suggests AMPA-receptor antibody, and AMPA-receptor antibody cell-binding assay (CBA) is positive, then AMPA-receptor antibody IF titer assay is performed at an additional charge.
If AMPA-receptor antibody CBA is positive, then CRMP-5-IgG Western blot, ACh receptor (muscle) binding antibody, and ACh receptor (muscle) modulating antibody are performed at an additional charge.
If CASPR2-receptor antibody CBA is positive, then CRMP-5-IgG Western blot, ACh receptor (muscle) binding antibody, and ACh receptor (muscle) modulating antibody are performed at an additional charge.
If IFA pattern suggests GABA-B-receptor antibody, and GABA-B-R receptor antibody CBA is positive, then GABA-B-R receptor antibody IF titer assay is performed at an additional charge.
If IFA pattern suggests GFAP antibody, GFAP IFA Titer and GFAP CBA are performed at an additional charge.
If IFA pattern suggests NMDA-receptor antibody, and NMDA-receptor antibody CBA is positive, then NMDA-receptor antibody IF titer assay is performed at an additional charge.
If IFA patterns suggest PCA-1, then Purkinje cell cytoplasmic antibody type 1 (PCA-1) immunoblot is performed at an additional charge.
If IFA pattern suggest PCA-Tr antibody, then PCA-Tr immunoblot is performed at an additional charge,
If IFA pattern suggests DPPX antibody, then DPPX antibody CBA and DPPX titer are performed at an additional charge.
If IFA pattern suggests mGluR1 antibody, then mGluR1 antibody CBA and mGluR1 titer are performed at an additional charge.
If IFA pattern suggests IgLON5 antibody, then IgLON5 antibody CBA and IgLON5 IFA titer are performed at an additional charge.
If IFA pattern suggests NIF antibody, then alpha internexin CBA NIF heavy chain CBA, NIF light chain CBA, and NIF IFA titer are performed at an additional charge.
See Dementia Autoimmune Evaluation Algorithm-Serum in Special Instructions.
Special Instructions
Method Name
AINCS, AMPCS, CS2CS, DPPCS, GABCS, GFACS, GL1CS, IG5CS, LG1CS, NFHCS, NFLCS, NMDCS: Cell Binding Assay (CBA)
AGN1S, AMPHS, AMPIS, ANN1S, ANN2S, ANN3S, CRMS, DPPIS, DPPTS, GABIS, GFAIS, GFATS, GL1IS, GL1TS, IG5IS, IG5TS, NIFIS, NIFTS, NMDIS, PCAB2, PCABP, PCATR: Indirect Immunofluorescence Assay (IFA)
ARBI, CCN, CCPQ, GANG, GD65S: Radioimmunoassay (RIA)
ARMO: Live Cell Assay (LCA)
CRMWS: Western Blot (WB)
AGNBS, AMIBS, AN1BS, AN2BS, PC1BS, PCTBS: Immunoblot (IB)
Reporting Name
Dementia Autoimmune Eval, SSpecimen Type
SerumSpecimen Minimum Volume
2.5 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Serum | Refrigerated (preferred) | 28 days | |
| Frozen | 28 days | ||
| Ambient | 72 hours |
Reject Due To
| Gross hemolysis | Reject |
| Gross lipemia | Reject |
| Gross icterus | Reject |
Reference Values
|
Test ID |
Reporting name |
Methodology |
Reference value |
|
GANG |
AChR Ganglionic Neuronal Ab, S |
Radioimmunoassay (RIA) |
≤0.02 nmol/L |
|
AMPCS |
AMPA-R Ab CBA, S |
Cell-binding assay (CBA) |
Negative |
|
AMPHS |
Amphiphysin Ab, S |
Indirect immunofluorescence assay (IFA) |
<1:240 |
|
AGN1S |
Anti-Glial Nuclear Ab, Type 1 |
IFA |
<1:240 |
|
ANN1S |
Anti-Neuronal Nuclear Ab, Type 1 |
IFA |
<1:240 |
|
ANN2S |
Anti-Neuronal Nuclear Ab, Type 2 |
IFA |
<1:240 |
|
ANN3S |
Anti-Neuronal Nuclear Ab, Type 3 |
IFA |
<1:240 |
|
CS2CS |
CASPR2-IgG CBA, S |
CBA |
Negative |
|
CRMS |
CRMP-5-IgG, S |
IFA |
<1:240 |
|
DPPIS |
DPPX Ab IFA, S |
IFA |
Negative |
|
GABCS |
GABA-B-R Ab CBA, S |
CBA |
Negative |
|
GD65S |
GAD65 Ab Assay, S |
RIA |
≤0.02 nmol/L Reference values apply to all ages. |
|
GFAIS |
GFAP IFA, S |
IFA |
Negative |
|
IG5IS |
IgLON5 IFA, S |
IFA |
Negative |
|
LG1CS |
LGI1-IgG CBA, S |
CBA |
Negative |
|
GL1IS |
mGluR1 Ab IFA, S |
IFA |
Negative |
|
NIFIS |
NIF IFA, S |
IFA |
Negative |
|
NMDCS |
NMDA-R Ab CBA, S |
CBA |
Negative |
|
CCN |
N-Type Calcium Channel Ab |
RIA |
≤0.03 nmol/L |
|
CCPQ |
P/Q-Type Calcium Channel Ab |
RIA |
≤0.02 nmol/L |
|
PCAB2 |
Purkinje Cell Cytoplasmic Ab Type 2 |
IFA |
<1:240 |
|
PCATR |
Purkinje Cell Cytoplasmic Ab Type Tr |
IFA |
<1:240 |
Reflex Information:
|
Test ID |
Reporting name |
Methodology |
Reference value |
|
ARBI |
ACh Receptor (Muscle) Binding Ab |
RIA |
≤0.02 |
|
ARMO |
ACh Receptor (Muscle) Modulating Ab |
Live-cell assay |
0-20% (reported as __% loss of AChR) |
|
AGNBS |
AGNA-1 Immunoblot, S |
Immunoblot (IB) |
Negative |
|
AINCS |
Alpha Internexin CBA, S |
CBA |
Negative |
|
AMPIS |
AMPA-R Ab IF Titer Assay, S |
IFA |
<1:120 |
|
AMIBS |
Amphiphysin Immunoblot, S |
IB |
Negative |
|
AN1BS |
ANNA-1 Immunoblot, S |
IB |
Negative |
|
AN2BS |
ANNA-2 Immunoblot, S |
IB |
Negative |
|
CRMWS |
CRMP-5-IgG Western Blot, S |
Western blot |
Negative |
|
DPPCS |
DPPX Ab CBA, S |
CBA |
Negative |
|
DPPTS |
DPPX Ab IFA Titer, S |
IFA |
<1:240 |
|
GABIS |
GABA-B-R Ab IF Titer Assay, S |
IFA |
<1:240 |
|
GFACS |
GFAP CBA, S |
CBA |
Negative |
|
GFATS |
GFAP IFA Titer, S |
IFA |
<1:240 |
|
IG5CS |
IgLON5 CBA, S |
CBA |
Negative |
|
IG5TS |
IgLON5 IFA Titer, S |
IFA |
<1:240 |
|
GL1CS |
mGluR1 Ab CBA, S |
CBA |
Negative |
|
GL1TS |
mGluR1 Ab IFA Titer, S |
IFA |
<1:240 |
|
NFHCS |
NIF Heavy Chain CBA, S |
CBA |
Negative |
|
NIFTS |
NIF IFA Titer, S |
IFA |
<1:240 |
|
NFLCS |
NIF Light Chain CBA, S |
CBA |
Negative |
|
NMDIS |
NMDA-R Ab IF Titer Assay, S |
IFA |
<1:120 |
|
PC1BS |
PCA-1 Immunoblot, S |
IB |
Negative |
|
PCABP |
Purkinje Cell Cytoplasmic Ab Type 1 |
IFA |
<1:240 |
|
PCTBS |
PCA-Tr Immunoblot, S |
IB |
Negative |
Neuron-restricted patterns of IgG staining that do not fulfill criteria for ANNA-1, ANNA-2, CRMP-5-IgG, PCA-1, PCA-2, or PCA-Tr may be reported as "unclassified anti-neuronal IgG." Complex patterns that include nonneuronal elements may be reported as "uninterpretable."
Note: CRMP-5 titers lower than 1:240 are detectable by recombinant CRMP-5 Western blot analysis. CRMP-5 Western blot analysis will be done on request on stored serum (held 4 weeks). This supplemental testing is recommended in cases of chorea, vision loss, cranial neuropathy, and myelopathy. Call the Neuroimmunology Laboratory at 800-533-1710 to request CRMP-5 Western blot.
Day(s) and Time(s) Performed
GL1CS, IG5CS:
Monday, Thursday; 6 p.m.
AGN1S, AMPHS, AMPIS, ANN1S, ANN2S, ANN3S, CRMS, DPPIS, DPPTS, GABIS, GFAIS, GFATS, GL1IS, GL1TS, IG5IS, IG5TS, NIFIS, NIFTS, NMDIS, PCAB2, PCABP, PCATR:
Monday through Friday; 5 a.m., 7 a.m. and 5 p.m.
Saturday, Sunday; 6 a.m.
AMPCS, CS2CS, DPPCS, GABCS, LG1CS, NMDCS:
Monday through Friday; 10 p.m.
Sunday; 10 p.m.
GFACS:
Monday, Wednesday, Friday; 6 p.m.
ARMO:
Monday through Thursday; 1 p.m.
Saturday; 8 a.m.
ARBI:
Monday through Friday; 11 a.m., 6 p.m., 10 p.m.
Saturday; 6 a.m.
Sunday; 6 a.m., 10 a.m.
CCN, CCPQ, GANG:
Monday through Friday; 6 a.m., 8 a.m., 6 p.m.
Saturday, Sunday; 7 a.m.
GD65S:
Monday through Friday; 5 a.m., 2 p.m.
Saturday, Sunday; 7 a.m.
CRMWS:
Monday through Thursday; 8 a.m.
AGNBS, AMIBS, AN1BS, AN2BS, PC1BS, PCTBS:
Monday through Friday; 6 p.m.
AINCS, NFHCS, NFLCS:
Tuesday, Thursday; 6 p.m.
Performing Laboratory
Mayo Clinic Laboratories in Rochester
Test Classification
This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the U.S. Food and Drug Administration.CPT Code Information
83519 x 3
86255 x18
86341 x 1
83519 ARBI (if appropriate)
83519 ARMO (if appropriate)
84182 AGNBS (if appropriate)
86255 AINCS (if appropriate)
86256 AMPIS (if appropriate)
84182 AMIBS (if appropriate)
84182 AN1BS (if appropriate)
84182 AN2BS (if appropriate)
84182 CRMWS (if appropriate)
86255 DPPCS (if appropriate)
86256 DPPTS (if appropriate)
86256 GABIS (if appropriate)
86255 GFACS (if appropriate)
86256 GFATS (if appropriate)
86255 IG5CS (if appropriate)
86256 IG5TS (if appropriate)
86255 GL1CS (if appropriate)
86256 GL1TS (if appropriate)
86255 NFHCS (if appropriate)
86256 NIFTS (if appropriate)
86255 NFLCS (if appropriate)
86256 NMDIS (if appropriate)
84182 PC1BS (if appropriate)
86255 PCABP (if appropriate)
84182 PCTBS (if appropriate)
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| DMS2 | Dementia Autoimmune Eval, S | 94696-2 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| 61516 | NMDA-R Ab CBA, S | 93503-1 |
| 61518 | AMPA-R Ab CBA, S | 93489-3 |
| 61519 | GABA-B-R Ab CBA, S | 93428-1 |
| 34255 | Dementia, Interpretation, S | 69048-7 |
| 64279 | LGI1-IgG CBA, S | 94287-0 |
| 64281 | CASPR2-IgG CBA, S | 94285-4 |
| 64930 | DPPX Ab IFA, S | 82976-2 |
| 64928 | mGluR1 Ab IFA, S | 94347-2 |
| 605155 | GFAP IFA, S | 94346-4 |
| 606946 | IgLON5 IFA, S | 96476-7 |
| 606964 | NIF IFA, S | 96486-6 |
| 80776 | ANNA-2, S | 94343-1 |
| 83137 | ANNA-3, S | 94344-9 |
| 81184 | N-Type Calcium Channel Ab | 94348-0 |
| 81185 | P/Q-Type Calcium Channel Ab | 94349-8 |
| 83077 | CRMP-5-IgG, S | 94815-8 |
| 84321 | AChR Ganglionic Neuronal Ab, S | 94694-7 |
| 81596 | GAD65 Ab Assay, S | 94345-6 |
| 83138 | PCA-2, S | 94351-4 |
| 83076 | PCA-Tr, S | 94352-2 |
| 89080 | AGNA-1, S | 94341-5 |
| 81722 | Amphiphysin Ab, S | 94340-7 |
| 80150 | ANNA-1, S | 94342-3 |
| 36349 | Reflex Added | 77202-0 |