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Encephalitis Antibody Evaluation with Reflex to Titer and Line Blot, CSF
Test Code94958
Alias/See Also
1230008254 | LAB2336: Encephalopathy Autoimmune Evaluation, CSF | QUEST EAP: 94958
CPT Codes
86255 (x19), 86052, 86341, 83519
Includes
If Encephalitis Antibody Screen, Tissue IFA w/reflexes, CSF suggests a fluorescence pattern consistent with one or more antibodies including AGNA1 (SOX1), Amphiphysin, ANNA1 (Hu), ANNA2 (Ri), CRMP5(CV2), GAD65, Ma2/Ta, PCA1 (Yo), PCA Tr (DNER), and Zic4, a line blot consisting of these 10 antibodies will be performed.
If the Encephalitis Antibody Screen, Tissue IFA w/reflexes, CSF suggests a fluorescence pattern consistent with ANNA3, titer will be performed.
If the Encephalitis Antibody Screen, Tissue IFA w/reflexes, CSF suggests a fluorescence pattern consistent with PCA2, titer will be performed.
If the Encephalitis Antibody Screen, Tissue IFA w/reflexes, CSF suggests a fluorescence pattern consistent with PCA Tr (DNER) and Neurology Antibody Line Blot shows PCA Tr (DNER) negative and PCA1 (Yo) negative, then PCA Tr (DNER) Ab, CBA, CSF will be performed at an additional charge (CPT code(s): 86255).
If PCA Tr (DNER) Ab, CBA, CSF is positive, titer will be performed.
If the Encephalitis Antibody Screen, Tissue IFA w/reflexes, CSF for Myelin suggests a fluorescence pattern consistent with Myelin Antibody, titer will be performed at an additional charge (CPT code(s): 86256).
If the Neurology Antibody, CBA is positive for NMDAR1, AMPAR2, LGI1, or CASPR2, titers will be performed at an additional charge (CPT code(s): 86256 for each titer performed).
If the Aquaporin 4 (AQP4) Ab, CBA is positive, titer will be performed at an additional charge (CPT code (s): 86052).
If the Neurology Antibody, CBA is positive for AMPAR1 or GABABR, titers will be performed.
If the DPPX Antibody, CBA is positive, titer will be performed.
If the Encephalitis Antibody Screen, Tissue IFA w/reflexes, CSF suggests a fluorescence pattern consistent with ANNA3, titer will be performed.
If the Encephalitis Antibody Screen, Tissue IFA w/reflexes, CSF suggests a fluorescence pattern consistent with PCA2, titer will be performed.
If the Encephalitis Antibody Screen, Tissue IFA w/reflexes, CSF suggests a fluorescence pattern consistent with PCA Tr (DNER) and Neurology Antibody Line Blot shows PCA Tr (DNER) negative and PCA1 (Yo) negative, then PCA Tr (DNER) Ab, CBA, CSF will be performed at an additional charge (CPT code(s): 86255).
If PCA Tr (DNER) Ab, CBA, CSF is positive, titer will be performed.
If the Encephalitis Antibody Screen, Tissue IFA w/reflexes, CSF for Myelin suggests a fluorescence pattern consistent with Myelin Antibody, titer will be performed at an additional charge (CPT code(s): 86256).
If the Neurology Antibody, CBA is positive for NMDAR1, AMPAR2, LGI1, or CASPR2, titers will be performed at an additional charge (CPT code(s): 86256 for each titer performed).
If the Aquaporin 4 (AQP4) Ab, CBA is positive, titer will be performed at an additional charge (CPT code (s): 86052).
If the Neurology Antibody, CBA is positive for AMPAR1 or GABABR, titers will be performed.
If the DPPX Antibody, CBA is positive, titer will be performed.
Preferred Specimen
4 mL CSF collected in a sterile leak-proof container
Minimum Volume
2 mL
Transport Temperature
Refrigerated (cold packs)
Specimen Stability
Room temperature: 24 hours
Refrigerated: 7 days
Frozen: 21 days
Refrigerated: 7 days
Frozen: 21 days
Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)
Received room temperature
Methodology
See individual assays
FDA Status
This test was developed and its analytical performance characteristics have been determined by Quest Diagnostics. It has not been cleared or approved by FDA. This assay has been validated pursuant to the CLIA regulations and is used for clinical purposes.
Setup Schedule
Set up: Tues; Report available: 4-13 days
Reference Range
See Laboratory Report
Clinical Significance
Encephalitis due to anti-neuronal autoantibodies may present in a variety of ways and may be associated with a variety of tumors. Screening for anti-neuronal autoantibodies is performed using tissue immunofluorescence with confirmation by line blot assay. This CSF panel also includes additional testing for autoantibodies frequently associated with encephalitis such as NMDA receptor using cell-based assays. Testing using both serum and CSF increases sensitivity for detection.
Performing Laboratory
| Quest Diagnostics Nichols Institute-San Juan Capistrano, CA |
| 33608 Ortega Highway |
| San Juan Capistrano, CA 92675-2042 |
Last Updated: April 21, 2023
