Paraneoplastic, Autoantibody Evaluation, Serum
Order Code:
PAVAL
Test Summary
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
Aliases
- Paraneoplastic Antibodies, Paraneoplastic Neurological Autoimmunity
Specimen Collection
Special Instructions
Utilization Guidance: PAVAL (Paraneoplastic, Autoantibody Evaluation, Serum) is not our recommended test for patients suspected of autoimmune neurological disorders. A comprehensive neurological phenotype-specific autoimmune/paraneoplastic evaluation (e.g. encephalopathy, movement disorders, myelopathy, axonal neuropathy, etc. ) should be considered.
Preferred Specimen
4 mL serum from a red top tube
Minimum Volume
2 mL serum
Instructions
N/A
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.
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.
Storage
Plastic screw-cap vial
Transport Temperature
Refrigerated
Specimen Stability
- Room Temperature: 72 hours
- Refrigerated: 28 days
- Frozen: 28 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.
Other Acceptable Specimens
Serum from a serum separator tube
Unacceptable Specimens
Gross hemolysis, gross lipemia, gross icterus
Order Code
PAVAL
EPIC (Premier) Code
LAB6458
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
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
CPT Code
- 86255x9
Billing Code
- 650030
- 650029
- 650031
CPT Statement
Methodology
Indirect Immunofluorescence Assay, Radioimmunoassay, Cell-Binding Assay
FDA Status
This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.
Physician Attestation of Informed Consent
N/A
Testing Laboratory
Mayo Clinic Laboratories
200 First Street SW
Rochester MN, 55905
200 First Street SW
Rochester MN, 55905
Department
Reference Testing
Reference Range
N/A
Setup Schedule / Expected Turnaround Time
Monday - Sunday; Report available: 10 - 17 days
Specimen Collection
Special Instructions
Utilization Guidance: PAVAL (Paraneoplastic, Autoantibody Evaluation, Serum) is not our recommended test for patients suspected of autoimmune neurological disorders. A comprehensive neurological phenotype-specific autoimmune/paraneoplastic evaluation (e.g. encephalopathy, movement disorders, myelopathy, axonal neuropathy, etc. ) should be considered.
Preferred Specimen
4 mL serum from a red top tube
Minimum Volume
2 mL serum
Instructions
N/A
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.
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.
Storage
Plastic screw-cap vial
Transport Temperature
Refrigerated
Specimen Stability
- Room Temperature: 72 hours
- Refrigerated: 28 days
- Frozen: 28 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.
Other Acceptable Specimens
Serum from a serum separator tube
Unacceptable Specimens
Gross hemolysis, gross lipemia, gross icterus
Result Information
Methodology
Indirect Immunofluorescence Assay, Radioimmunoassay, Cell-Binding Assay
Testing Laboratory
N/A
Reference Range
N/A
Setup Schedule / Expected Turnaround Time
Monday - Sunday; Report available: 10 - 17 days