Encephalitis Antibody Evaluation with Reflex to Titer and Line Blot

Collection Information: Collect 4 full tubes in order to obtain the preferred amount of serum. Immediate Specimen Processing: Centrifuge specimen before transporting to the lab. If drawn using a plain red-top tube, transfer serum to a plastic screw-cap tube prior to transportation. Submit all four (4) container s to the main lab Refrigerated Ambulatory Transport Temperature to Inova Central Lab: Refrigerated Specimen Stability: 48 hours

LAB16176 ENCEP

ENCEP

Initial panel consits of: Encephalitis Ab Screen Tissue IFA, AMPAR1, AMPAR2, Aquaporin 4, DPPX, GABAbR, NMDAR1, CASPAR2, LGI1, Ganglionic AChR, VGCC N-Type, VGCC P/Q-Type, and VGKC.1) A line blot consisting of 10 analytes will be performed at an additional charge (CPT codes(s): 84182 x9, 86341) as a reflex for tissue mosaic IFA suggesting one or more of the analytes on the line blot: ANNA1 (Hu), ANNA2 (Ri), PCA1 (Yo), Ma2/Ta, CV2 (CRMP5), Amphiphysin, AGNA1 (SOX1), GAD65, DNER, and Zic4. If the tissue mosaic pattern suggests ANNA3, then titer will be performed at an additional charge (CPT code(s): 86256).2) If the tissue mosaic pattern suggests PCA-2, then titer will be performed at an additional charge (CPT code(s): 86256).3) If the tissue mosaic IFA suggests PCA-Tr (DNER) and Western Blot shows DNER negative and Yo negative, then cell based assay IFA for DNER will be performed at an additional charge (CPT codes(s): 86255)a. If DNER CBA is positive, then titer will be performed at an additional charge (CPT code(s): 86256).4) If the tissue mosaic IFA suggests myelin antibody, thena. Myelin antibody IFA titer will be performed at an additional charge (CPT code(s): 86256).b. Myelin Associated Glycoprotein (MAG) Antibody, in turn reflexing to MAG-SGPG and MAG ELISA for quantitation, will be performed at an additional charge (CPT code(s): 83520 x2).5) If the Mosaic CBA is positive for any given analyte (NMDAR1, AMPAR1, AMPAR2, GABA-B Receptor, LGI-1, CASPR2), and the individual CBAs DPPX and Aquaporin 4 antibody, then that analyte will be titered at an additional charge (CPT code(s): 86256 per titer, 86052 for AQP4 Titer).6) If DPPX is positive, then titer will be performed at an additional charge (CPT code(s): 86256).7) If the Aquaporin 4 (NMO, neuromyelitis optica) CBA is positive, then Aquaporin 4 CBA titer will be performed at an additional charge (CPT code(s): 86052).@BKRCERMSGREFRESH(2302793)@ @BKRCERMSGREFRESH(2302794)@

Processing Instructions: Serum from all collection container s can be poured into 1 plastic screw-cap tube.Preferred Volume: 8 mL serumMinimum Volume: 4 mL serumTransport Temperature: Refrigerated Stability: Ambient: 24 hoursRefrigerated : 14 daysFrozen: 21 days Causes for Rejection: Gross hemolysis Gross lipemia Gross icterusTurbid Bacterial contamination freeze/thaw greater than 3 cyclesPerforming Lab: Quest - San Juan Capistrano (SJC)

13-Days

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