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Overview
ข้อมูลทั่วไป Specimen
ข้อมูลสิ่งส่งตรวจ Performance
ข้อมูลการทดสอบ Clinical & Interpretation
ข้อมูลทางคลินิก
 
Test Code (รหัสการทดสอบ):
090-81-2026
Order Name (ชื่อการทดสอบ):
Encephalopathy, Autoimmune (Paraneoplastic) Evaluation, Serum (MAYO) **
 
Specimen / Container (สิ่งส่งตรวจ/ภาชนะ):
Blood/ Plain blood (Red top) 6 mL, 4 tubes

NECESSARY INFORMATION
Provide the following information:
-Relevant clinical information
-Ordering provider name, phone number, mailing address, and e-mail address
 
Turnaround Time (ระยะเวลารอผล):
21 days
 
Useful For (ประโยชน์การทดสอบ):
Evaluating new onset encephalopathy (noninfectious or metabolic) comprising confusional states, psychosis, delirium, memory loss, hallucinations, movement disorders, sensory or motor complaints, seizures, dyssomnias, ataxias, nausea, vomiting, inappropriate antidiuresis, coma, dysautonomias, or hypoventilation using serum specimens.

This test is designed for patients age 18 and older.
 
Methodology (วิธีการทดสอบ):
- Indirect Immunofluorescence Assay (IFA)
- Cell Binding Assay (CBA)
- Western Blot (WB)
- Immunoblot (IB)
- Radioimmunoassay (RIA)
- Medical Interpretation
 
 
Test List In Profile (การทดสอบใน Profile):
Encephalopathy, Interpretation, S
AMPA-R Ab CBA, S
Amphiphysin Ab, S
Anti-Glial Nuclear Ab, Type 1
Anti-Neuronal Nuclear Ab, Type 1
Anti-Neuronal Nuclear Ab, Type 2
Anti-Neuronal Nuclear Ab, Type 3
CASPR2-IgG CBA, S
CRMP-5-IgG, S
DPPX Ab CBA, S
GABA-B-R Ab CBA, S
GAD65 Ab Assay, S
GFAP IFA, S
mGluR1 Ab IFA, S
IgLON5 CBA, S
LGI1-IgG CBA, S
Neurochondrin IFA, S
NIF IFA, S
NMDA-R Ab CBA, S
Purkinje Cell Cytoplasmic Ab Type 1
Purkinje Cell Cytoplasmic Ab Type 2
Purkinje Cell Cytoplasmic Ab Type Tr
PDE10A Ab IFA, S
Septin-7 IFA, S
TRIM46 Ab IFA, S

Plus auto-reflex as algorithm
 
 
 
Test Code (รหัสการทดสอบ):
090-81-2026
Order Name (ชื่อการทดสอบ):
Encephalopathy, Autoimmune (Paraneoplastic) Evaluation, Serum (MAYO) **
 
Patient Preparation (การเตรียมตัวผู้ป่วย):
For optimal antibody detection, specimen collection is recommended prior to initiation of immunosuppressant medication or intravenous immunoglobulin treatment.

Remark:
This test is intended to be ordered for adult patients (age 18 and older only).

This test should not be requested for 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.
 
Collection Specimen Or Container (สิ่งส่งตรวจ/ภาชนะ):
Blood/ Plain blood (Red top) 6 mL, 4 tubes

NECESSARY INFORMATION
Provide the following information:
-Relevant clinical information
-Ordering provider name, phone number, mailing address, and e-mail address
 
Specimen Testing Type (สิ่งส่งตรวจที่ใช้ในการทดสอบ):
Serum, minimum volume 3 mL x 2 tubes
 
Sub Mission Container (ภาชนะส่งตรวจ):
Plastic tube
 
Rejection Criteria (เกณฑ์ปฏิเสธสิ่งส่งตรวจ):
Gross hemolysis
Gross lipemia
Gross icterus
Patient age under 18
 
Specimen Stabillity (ความคงตัวของสิ่งส่งตรวจ):
Serum: 
- Refrigerated 28 days    
- Frozen     28 days    
- Ambient 72 hours
 
 
 
Test Code (รหัสการทดสอบ):
090-81-2026
Order Name (ชื่อการทดสอบ):
Encephalopathy, Autoimmune (Paraneoplastic) Evaluation, Serum (MAYO) **
 
Schedule (ตารางการทดสอบ):
N/A **Sent out to MAYO, USA
 
Turnaround Time (ระยะเวลารอผล):
21 days
 
Performing Location (หน่วยงานที่ทำการทดสอบ):
MAYO Laboratory
Referral Lab Services, Laboratory Department 14160-2
 
 
 
Test Code (รหัสการทดสอบ):
090-81-2026
Order Name (ชื่อการทดสอบ):
Encephalopathy, Autoimmune (Paraneoplastic) Evaluation, Serum (MAYO) **
 
 
Clinical Information (ข้อมูลทางคลินิก):
Evaluating new onset encephalopathy (noninfectious or metabolic) comprising confusional states, psychosis, delirium, memory loss, hallucinations, movement disorders, sensory or motor complaints, seizures, dyssomnias, ataxias, nausea, vomiting, inappropriate antidiuresis, coma, dysautonomias, or hypoventilation using serum specimens 

The following accompaniments should increase of suspicion for autoimmune encephalopathy:
-Headache
-Autoimmune stigmata (personal or family history or signs of diabetes mellitus, thyroid disorder, vitiligo, poliosis [premature graying], myasthenia gravis, rheumatoid arthritis, systemic lupus erythematosus)
-History of cancer
-Smoking history (20 or more pack-years) or other cancer risk factors
-Inflammatory cerebral spinal fluid (or isolated protein elevation)
-Neuroimaging signs suggesting inflammation

Evaluating limbic encephalitis (noninfectious)

Directing a focused search for cancer

Investigating encephalopathy appearing during or after cancer therapy and not explainable by metastasis or drug effect
 
Reference Value (ค่าอ้างอิง):
The interpete report will be provided
 
Interpretation (การแปลผล):
INTERPRETATION 
Neuronal, glial, and muscle autoantibodies are valuable serological markers of autoimmune encephalopathy and of a patient's immune response to cancer. These autoantibodies are usually accompanied by subacute neurological symptoms and signs are not found in healthy subjects. It is not uncommon for more than 1 of the following autoantibody specificities to be detected in patients with an autoimmune encephalopathy:
-Plasma membrane autoantibodies: N-methyl-D-aspartate (NMDA) receptor; 2-amino-3-(5-methyl-3-oxo-1,2- oxazol-4-yl) propanoic acid (AMPA) receptor; gamma-amino butyric acid (GABA-B) receptor; neuronal ACh receptor. These are all potential effectors of neurological dysfunction.
-Neuronal nuclear autoantibodies, type 1 (ANNA-1), type 2 (ANNA-2), or type 3 (ANNA-3)
-Neuronal or muscle cytoplasmic antibodies: amphiphysin, Purkinje cell antibodies (PCA-1) and PCA-2, CRMP-5, GAD65, or striational

CAUTIONS 
Negative results do not exclude autoimmune encephalopathy or cancer.
 
This test does not detect Ma1 or Ma2 antibodies (also known as MaTa), which are sometimes associated with brainstem and limbic encephalitis in the context of testicular germ cell neoplasms. Scrotal ultrasound is advised for men who present with unexplained subacute encephalitis.
 
Intravenous immunoglobulin treatment prior to the serum collection may cause a false-positive result.
 
Clinical Reference (เอกสารอ้างอิง):
www.mayomedicallaboratories.com (Retrieved: 22 Jul 2024)