leading the way in autoantibody evaluations · accurate diagnosis is paramount, our testing...
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N E U R O L O G Y A T M A Y O C L I N I C
M A Y O M E D I C A L L A B O R A T O R I E S . C O M / N E U R O L O G Y
A RAPIDLY EVOLVING SUBSPECIALTY
Muscle fatigue that immobilizes a young mom in the prime of her life. Seizures that strike a child without warning. A 45-year-old man’s puzzling forgetfulness.
Today, patients who present these symptoms can receive appropriate diagnoses — multiple sclerosis (MS), epilepsy and early-onset dementia, respectively — and embark on standard treatment protocols to improve quality of life.
But in cases triggered by the body’s autoimmune response, modern medicine falls short of attacking these diseases at their root causes, offering only temporary relief rather than cures.
Autoimmune neurology is a rapidly evolving subspecialty driven by the discovery that the immune system can target virtually any structure within the central or peripheral nervous system. These conditions manifest as disorders previously thought to be independent and unrelated.
For the spectrum of autoimmune neurological disorders, where an early and accurate diagnosis is paramount, our testing approaches to effectively diagnose and guide treatment for these patients is unparalleled.
A HISTORY OF INNOVATION & DISCOVERY Recognized as a world leader in the diagnosis and treatment of autoimmune neurologic disorders and demyelinating disease, Mayo Clinic mounts unmatched resources for uncovering novel syndromes, developing new diagnostic biomarkers and unique laboratory tests.
The Mayo Clinic Neuroimmunology Laboratory was the first to introduce comprehensive serological evaluations for the diagnosis of paraneoplastic neurologic autoimmune disorders, a group of disorders in which unusual neurologic signs and symptoms are the initial manifestations of cancer.
The laboratory continues to discover and clinically validate novel autoantibody profiles that inform neurological decision-making and guide the search for cancer.
Vanda Lennon, M.D., Ph.D.,
is the founder of the Mayo Clinic
Neuroimmunology Laboratory.
She is also the Dorothy A. Adair
Professor in the Departments of
Laboratory Medicine and Pathology,
Neurology and Immunology at the
College of Medicine at the Mayo Clinic.
COLLEGIAL ACCESS TO MAYO CLINIC NEUROLOGISTS Neurologists are available for consultation and assistance in the interpretation of autoantibody evaluations. These conversations enable the best diagnosis and treatment approach, as they provide our neurologists the opportunity to ask additional clinical information, as well as address the questions of the ordering neurologist.
CONTACT US AT 855-516-8404.
SYMPTOMS OF AUTOIMMUNE NEUROLOGICAL DISORDERS
} Vision loss} Spinal cord disorders} Movement disorders} Dementia, epilepsy and
encephalopathy} Myelopathy} Paraneoplastic (cancer-related)
neurological disorders} Nerve, muscle and
neurotransmission disorders (neuropathy, myositis and myasthenia gravis)
} Autonomic disorders (e.g., AGID – autoimmune gastrointestinal dysmotility).
C U S T O M E R S E R V I C E F O R C L I N I C A L S P E C I A L I S T S / 8 5 5 - 5 1 6 - 8 4 0 4
A U T O I M M U N E N E U R O L O G I C A L D I S O R D E R S
LABORATORY DIRECTORS1 SEAN PITTOCK, M.D.2 ANDREW MCKEON, M.D.
CONSULTANTS3 EOIN FLANAGAN, M.B., B.CH.4 CHRISTOPHER KLEIN, M.D.5 DANIEL LACHANCE, M.D.
1 2 4 53
NEURAL ANTIBODIES EVALUATEDANTIBODY COMMON NEUROLOGIC FINDINGS
ANNA-1 (anti-Hu) Limbic encephalitis, brainstem encephalitis, automatic neuropathies, sensory neuronopathy
ANNA-2 (anti-Ri) Limbic encephalitis, brainstem encephalitis, myelopathy, peripheral neuropathy
ANNA-3 Limbic encephalitis, brainstem encephalitis, myelopathy, peripheral neuropathy
AGNA (SOX-1 antibodies) Limbic encephalitis, neuropathy, Lambert-Eaton syndrome
PCA-1 (anti-Yo) Cerebellar ataxia, brainstem encephalitides, myelopathies, peripheral neuropathies
PCA-2Limbic encephalitis, ataxia, brainstem encephalitis, Lambert-Eaton syndrome, peripheral and autonomic neuropathies
PCA-Tr Cerebellar ataxia, peripheral neuropathies
CRMP-5 IgG (anti-CV2)Subacute-onset dementia, personality change, aphasia, depression, chorea, ataxia, myelopathy, radiculopathy, neuropathy
AmphiphysinLimbic encephalitis, aphasia, other subacute-onset dementias, stiff person phenomena, myelopathy, neuropathy
VGKC complex, including LGI1 and CASPR2
Limbic encephalitis, amnestic syndrome, executive dysfunction, personality change, disinhibition, hypothalamic disorder, brainstem encephalitis, ataxia, extrapyramidal disorders, myoclonus, peripheral and autonomic neuropathy
NMDA receptor Amnestic syndrome, anxiety, psychosis, seizures, extrapyramidal disorders
AMPA receptor Limbic encephalitis, nystagmus, seizures
GABA-B receptor Encephalitis, seizures
P/Q- and N- type calcium channel antibodies
Lambert-Eaton syndrome, ataxias, encephalomyelopathies
Ganglionic AChR complex Somatic and autonomic peripheral neuropathies
Striational antibodies Typically nonspecific in isolation, but also with myasthenia gravis
Muscle AChR binding and modulating
Myasthenia gravis
GAD-65Stiff-man syndrome, ataxia, seizures, brainstem encephalitis, ophthalmoplegia, parkinsonism, myelopathy, limbic encephalitis, other encephalitides; also type 1 diabetes mellitus
AQP4-IgG Optic neuritis, longitudinally extensive transverse myelitis; reports of encephalopathies in children
MC2775-144rev0617
@mayocliniclabs/mayocliniclabsnews.mayomedicallaboratories.commayomedicallaboratories.com
FOR MORE INFORMATION ABOUT AUTOIMMUNE NEUROLOGY TESTINGMayoMedicalLaboratories.com/neurology
CENTRAL NERVOUS SYSTEM DISORDERS MAYO TEST ID TURNAROUND TIME
Encephalopathy, Autoimmune Evaluation, Serum
Encephalopathy, Autoimmune Evaluation, Spinal Fluid
ENS1
ENC1
4–7 days
3–5 days
Dementia, Autoimmune Evaluation, Serum
Dementia, Autoimmune Evaluation, Spinal Fluid
DMS1
DMC1
4–7 days
3–5 days
Epilepsy, Autoimmune Evaluation, Serum
Epilepsy, Autoimmune Evaluation, Spinal Fluid
EPS1
EPC1
4–7 days
3–5 days
PARANEOPLASTIC, PERIPHERAL NERVE, AND AUTONOMIC DISORDERSParaneoplastic, Autoantibody Evaluation, Serum
Paraneoplastic, Autoantibody Evaluation, Spinal Fluid
PAVAL
PAC1
10–17 days
3–5 days
Autoimmune Dysautonomia Evaluation, Serum DYS1 7 days
Ganglioside Antibody Panel, Serum GM1B 3 days
Glutamic Acid Decarboxylase (GAD65) Antibody Assay, Serum
Glutamic Acid Decarboxylase (GAD65) Antibody Assay, Spinal Fluid
GD65S
GD65C
2–3 days
2–3 days
Collapsin Response-Mediator Protein-5-IgG (CRMP-5-IgG) Western Blot, Serum
Collapsin Response-Mediator Protein-5-IgG (CRMP-5-IgG) Western Blot, Spinal Fluid
CRMWS
CRMWC
3–5 days
3–5 days
NEUROMUSCULAR JUNCTION DISORDERSMyasthenia Gravis Evaluation with MuSK MGRM 3 days
Myasthenia Gravis (MG) Evaluation, Adult MGA1 3 days
Myasthenia Gravis (MG) Evaluation, Pediatric MGP1 3 days
Myasthenia Gravis (MG)/Lambert-Eaton Syndrome (LES) Evaluation MGL1 3 days
Myasthenia Gravis (MG) Evaluation, Thymoma MGT1 3 days
Acetylcholine Receptor (Muscle AChR) Binding Antibody ARBI 3 days
Muscle-Specific Kinase (MuSK) Autoantibody MUSK 3 days
NEUROMYELITIS OPTICA (NMO) SPECTRUM DISORDERSNeuromyelitis Optica (NMO)/Aquaporin-4-IgG Fluorescence-Activated Cell Sorting (FACS) Assay, Serum
Neuromyelitis Optica (NMO)/Aquaporin-4-IgG Fluorescence-Activated Cell Sorting (FACS) Assay, Spinal Fluid
NMOFS
NMOFC
5 days
5 days
FOLLOW-UP ASSAYS (USED FOR FOLLOW-UP AFTER POSITIVE EVALUATION)Neuroimmunology Antibody Follow-up, Serum
Neuroimmunology Antibody Follow-up, Spinal Fluid
PNEFS
PNEFC
Varies
Varies
AUTOIMMUNE NEUROLOGY TESTING