Paraneoplastic Autoantibody Evaluation, Serum (Sendout)
General Information
- Lab Name
- Paraneoplastic Autoantibody Evaluation, Serum (Sendout)
- Lab Code
- RPNPV
- Epic Name
- Paraneoplastic Autoantibody Evaluation, Serum (Sendout)
- External Test Id
- PAVAL
- 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
- For a complete list of tests and potential reflex tests included in this panel, refer to the Mayo Paraneoplastic Evaluation Algorithm - Serum.
Ordering Guidance: The Paraneoplastic Autoantibody Evaluation is not the 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. For additional guidance, review the Autoimmune Encephalitis Testing Recommendations or consult the Laboratory Medicine Resident on-call.
Individual Antibody Follow-Up Testing: Individual antibody tests within the Paraneoplastic Autoantibody Evaluation are available for patients who have previously tested positive for those antibodies within the past five years at a Mayo laboratory. Refer to Mayo test: Neuroimmunology Antibody Follow-up, Serum.
***Order Alert: Effective 04/10/2025, the Neuronal (V-G) K+ Channel Antibody (VGKC) and P/Q-Type Calcium Channel Antibody tests are no longer performed as part of this panel. The components will be reported as "test not performed" until battery revision is complete in May 2025.***
- Synonyms
- AGNA-1, Amphiphysin Ab, ANNA-1, ANNA-2, ANNA-3, Anti Glial Nuclear Antibody 1, Anti Neuronal Nuclear Antibody 1, Anti Neuronal Nuclear Antibody 2, Anti Neuronal Nuclear Antibody 3, Anti-Glial Nuclear Antibody Type 1, CRMP-5 IgG, PAVAL, PCA-1, PCA-2, PCA-Tr, Purkinje Cell Cytoplasmic Antibody Type 1, Purkinje Cell Cytoplasmic Antibody Type 2, Purkinje Cell Cytoplasmic Antibody Type Tr
- Components
-
Code Name RPNPEV Paraneoplastic AutoAb Evaluation (Sendout) RANN1 Anti Neuronal Nuclear Antibody 1 RANN2 Anti Neuronal Nuclear Antibody 2 RANN3 Anti Neuronal Nuclear Antibody 3 RAGNA1 Anti Glial Nuclear Antibody 1 RPCA1 Purkinje Cell Cytoplasmic Antibody 1 RPCA2 Purkinje Cell Cytoplasmic Antibody 2 RPCATR Purkinje Cell Cytoplasmic Antibody Tr RAMPHS Amphiphysin Antibody RCRMP CRMP 5 IgG RCCPQ P/Q Type Calcium Channel Ab RNVGCK Neuronal (V_G) K Channel Ab RPNINT Paraneoplastic AutoAb Interp UW437 UW Imm_Study Paraneoplastic AutoAb
Interpretation
- Guidelines
- Method
Panel and reflex tests include the following methods: Immunofluorescence assay (IFA), Cell-binding assay (CBA), Western blot (WB), Radioimmunoassay (RIA), Immunoblot (IB)
- Reference Range
- See individual components
- Ref. Range Notes
Reference Values:
Amphiphysin Antiibody: Negative Anti-Glial Nuclear Antibody Type 1 (AGNA-1): Negative Anti-Neuronal Nuclear Antibody Type 1 (ANNA-1): Negative Anti-Neuronal Nuclear Antibody Type 2 (ANNA-2): Negative Anti-Neuronal Nuclear Antibody Type 3 (ANNA-3): Negative Collapsin Response-Mediator Protein-5 (CRMP-5) IgG: Negative Purkinje Cell Cytoplasmic Antibody Type 1 (PCA-1): Negative Purkinje Cell Cytoplasmic Antibody Type 2 (PCA-2): Negative Purkinje Cell Cytoplasmic Antibody Type Tr (PCA-Tr): Negative Note: Includes reference values for panel tests only.
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."
CRMP-5 Note: CRMP-5 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.
Interpretation: Antibodies directed at onconeural proteins shared by neurons, glia, muscle, and certain cancers are valuable serological markers of a patient's immune response to cancer. They are not found in healthy subjects and are usually accompanied by subacute neurological symptoms and signs. Several autoantibodies have a syndromic association, but no autoantibody predicts a specific neurological syndrome. Conversely, a positive autoantibody profile has 80% to 90% predictive value for a specific cancer. It is not uncommon for more than one paraneoplastic autoantibody to be detected, each predictive of the same cancer.
Ordering & Collection
- Specimen Type
- Blood
- Collection
-
12 mL blood in RED TOP tubes or GOLD SSTs
- Handling Instructions
Outside Laboratories: Centrifuge sample and transfer serum into a separate plastic vial. Refrigerate serum.
Stability: Refrigerated (preferred): 28 days; Frozen: 28 days; Ambient: 72 hours.
Reject Due To: Gross hemolysis, lipemia, icterus.
- Quantity
-
Requested: 4 mL serum + 1 mL for UW437
Minimum: 2 mL serum
Processing
- Receiving Instructions
Centrifuge samples and transfer 4 mL serum (2 mL minimum) into the RPNPEV aliquot. If specimen volume allows, aliquot 1 mL serum into a separate plastic vial for Immunology (UW437). Prioritize the sendout test (RPNPEV).
- RPNPEV: Refrigerate 4 mL serum (2 mL minimum) in the Sendouts Mayo rack.
- UW437: Freeze 1 mL serum at -20°C in Immunology rack.
If individual antibodies are requested (with a previous positive result within the last 5 years at Mayo), refer to separate test guide #982 (Neuroimmunology Follow-up, PNEFS).
Sendouts:
- Order Mayo Test: PAVAL
- Interfaced: Yes [Interface: 601: Worksheet: MARF]
Stability: Refrigerated (preferred): 28 days; Frozen: 28 days; Ambient: 72 hours.
Reject Due To: Gross hemolysis, lipemia, icterus.
- Misc Sendout
Performance
- Lab Department
- Frequency
- Performed: Monday - Sunday. Reflex tests: Varies. Report Available: 10-17 days from sample receipt at the performing laboratory.
- Available STAT?
- No
- Performing Location(s)
-
Sendout Mayo Clinic Laboratories
800-533-1710200 First Street Southwest
Rochester, MN 55901
Billing & Coding
- CPT Codes
- 86255x9
- LOINC
- 43104-9
- Interfaced Order Code
- UOW3348