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PPABS / PAVAL-M
PARANEOPLASTIC AUTOANTIBODY EVALUATION, SERUM

Test Code PPABS / PAVAL-M 
Test PARANEOPLASTIC AUTOANTIBODY EVALUATION, SERUM 
Methodology Indirect Immunofluorescence Assay (IFA): PANN1, PANN2, PANN3, PAPC1, PAPC2, PAPCT, PAAMP, PACRM, PAGL1, AMPTI, NMDTI, GABTI
Enzyme Immunoassay (EIA): STMAB
Radioimmunoassay (RIA): PAPQ, PAN, ACHRB, ACMOD, ACRGN, VGKC
Western Blot: PAWB, CRMP5, PAAWB
Cell-binding assay (CBA): NMDAB, AMPAB, GABAB
Interpretive Comment: NMINT 
Description Useful for 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. 
Specimen 4 mL Serum from a Gold Top Tube (SST)

Spin down and send refrigerated 

Reference Values NEURONAL NUCLEAR ANTIBODIES
Antineuronal Nuclear Antibody-Type 1 (ANNA-1)
<1:240
Antineuronal Nuclear Antibody-Type 2 (ANNA-2)
<1:240
Antineuronal Nuclear Antibody-Type 3 (ANNA-3)
<1:240
Anti-Glial/Neuronal Nuclear Antibody-Type 1 (AGNA-1)
<1:240

NEURONAL AND MUSCLE CYTOPLASMIC ANTIBODIES
Purkinje Cell Cytoplasmic Antibody, Type 1 (PCA-1)
<1:240
Purkinje Cell Cytoplasmic Antibody, Type 2 (PCA-2)
<1:240
Purkinje Cell Cytoplasmic Antibody, Type Tr (PCA-Tr)
<1:240
Amphiphysin Antibody
<1:240
CRMP-5-IgG
<1:240
Note: 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 or 507-266-5700 to request CRMP-5 Western blot.
Striational (Striated Muscle) Antibodies
<1:120

CATION CHANNEL ANTIBODIES
N-Type Calcium Channel Antibody
< or =0.03 nmol/L
P/Q-Type Calcium Channel Antibody
< or =0.02 nmol/L
AChR Ganglionic Neuronal Antibody
< or =0.02 nmol/L
Neuronal VGKC Autoantibody
< or =0.02 nmol/L
Neuron-restricted patterns of IgG staining that do not fulfill criteria for amphiphysin, ANNA-1, ANNA-2, ANNA-3, AGNA-1, PCA-1, PCA-2, PCA-Tr, or CRMP-5-IgG may be reported as "unclassified antineuronal IgG." Complex patterns that include non-neuronal elements may be reported as "uninterpretable."

ACHR RECEPTOR ANTIBODIES
ACh Receptor (Muscle) Binding Antibody
< or =0.02 nmol/L
AChR Receptor (Muscle) Modulating Antibody
0-20% loss of AChR

NEUROMYELITIS OPTICA (NMO)/AQUAPORIN-4-IGG FACS ASSAY
Negative
Paraneoplastic Western Blot
Negative
CRMP-5-IgG Western Blot
Negative
Amphiphysin Western Blot
Negative
N-Methyl-D-aspartate receptor (NMDA-R) CBA
Negative
IFA <1:120
2-amino-3-(5-methyl-3-oxo-1,2- oxazol-4-yl) propanoic acid receptor (AMPA-R) CBA
Negative
IFA <1:120
Gamma-Amino Butyric acid-type B receptor (GABA-B-R) CBA
Negative
IFA <1:120 
Analytic Time 10 Days (Negative), 17 Days (Confirmatory testing) 
Day(s) Test Set Up Varies per test component 
CPT Code(s) 83519  Neuronal VGKC autoantibody
83519  ACh receptor (muscle) binding antibody
83519  AChR ganglionic neuronal antibody
83519  N-type calcium channel antibody
83519  P/Q-type calcium channel antibody
83519  ACh receptor (muscle) modulating antibodies (if appropriate)
83520  Striational (striated muscle) antibodies
84182  Amphiphysin Western blot (if appropriate)
84182  CRMP-5-IgG Western blot (if appropriate)
84182  Paraneoplastic autoantibody Western blot confirmation (if appropriate)
86255  NMO/AQP4-IgG FACS (if appropriate)
86255  AMPCS (if appropriate)
86255  GABCS (if appropriate)
86255  NMDCS (if appropriate)
86255  AGNA-1
86255  Amphiphysin
86255  ANNA-1
86255  ANNA-2
86255  ANNA-3
86255  CRMP-5-IgG
86255  PCA-1
86255  PCA-2
86255  PCA-Tr
86256  AMPIS (if appropriate)
86256  GABIS (if appropriate)
86256  NMDIS (if appropriate)
86256  NMO/AQP4-IgG FACS titer (if appropriate)
86341  GAD65 antibody assay (if appropriate)