Paraneoplastic, Autoantibody Evaluation, Serum

Message

For Specimen Integrity during Extreme Weather see the “Lockbox Usage in Extreme Weather” document at the top of this page.

Test Code

PAVAL

Alias/See Also

Paraneoplastic Antibodies,
Paraneoplastic Neurological Autoimmunity

CPT Codes
83519; 86255x9, 86596

Includes

PAINT Interpretive Comments
AMPHS Amphiphysin Ab, S
AGN1S Anti-Glial Nuclear Ab, Type 1
ANN1S Anti-Neuronal Nuclear Ab, Type 1
ANN2S Anti-Neuronal Nuclear Ab, Type 2
ANN3S Anti-Neuronal Nuclear Ab, Type 3
CRMS CRMP-5-IgG, S
VGKC Neuronal (V-G) K+ Channel Ab, S
CCPQ P/Q-Type Calcium Channel Ab
PCABP Purkinje Cell Cytoplasmic Ab Type 1
PCAB2 Purkinje Cell Cytoplasmic Ab Type 2
PCATR Purkinje Cell Cytoplasmic Ab Type Tr

Preferred Specimen

4 mL serum Red Top Tube

Patient Preparation
Patient Preparation:
1. For optimal antibody detection, specimen collection is recommended prior to initiation of immunosuppressant medication or intravenous immunoglobulin (IVIg) treatment.
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.

Minimum Volume

2 mL serum

Other Acceptable Specimens

4 mL serum from SST

Instructions

Centrifuge Red Top tube, Aliquot Serum into a Pour off tube

Transport Container

Pour off tube

Transport Temperature

Refrigerated

Specimen Stability

Room Temperature: 72 hours
Refrigerated: 28 days
Frozen: 28 days

Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)

Gross hemolysis, gross lipemia, gross icterus

Methodology
Indirect Immunofluorescence Assay, Radioimmunoassay, Cell-Binding Assay

Setup Schedule

Daily

Report Available

10 - 17 days

Limitations

Negative results do not exclude cancer. Intravenous immunoglobulin (IVIg) treatment prior to the serum collection may cause a false-positive result. This evaluation does not include Ma2 autoantibody (alias MaTa). Ma2 autoantibody has been described in patients with brainstem and limbic encephalitis in the context of testicular germ cell neoplasms. Scrotal ultrasound is advisable in men who present with unexplained subacute encephalitis. N-methyl-D-asparate receptor antibodies have been reported in women with paraneoplastic encephalitis related to ovarian teratoma.

Clinical Significance

Serological evaluation of patients who present with a subacute neurological disorder of undetermined etiology, especially those with known risk factors for cancer
Directing a focused search for cancer Investigating neurological symptoms that appear in the course of, or after, cancer therapy, and are not explainable by metastasis
Differentiating autoimmune neuropathies from neurotoxic effects of chemotherapy
Monitoring the immune response of seropositive patients in the course of cancer therapy
Detecting early evidence of cancer recurrence in previously seropositive patients

Performing Laboratory
Mayo Clinic Laboratories
200 First Street SW
Rochester, MN 55905

Last Updated: August 8, 2023

The CPT Codes provided in this document are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payor being billed. Any Profile/panel component may be ordered separately. Reflex tests are performed at an additional charge.