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HelpPeripheral Nervous System Demyelinating Neuropathy, Autoimmune Evaluation, Serum
Additional Codes
Orderable Codes:
| Epic Code | Atlas Code | Mayo Test ID | Order LOINC |
| LAB17883 | LAB17883 | DMNES | 82455-7 |
Result Component(s):
| Reporting Name | Epic Code | Atlas Code | Mayo Test ID | Result LOINC |
| Demyelinating Neuropathy Interpretation, S. | 12301021343 | M621104 | 621104 | 69048-7 |
| Contactin-1 IgG CBA, S. | 12301021341 | M616442 | 616442 | 101448-9 |
| GQ1b-IgG ELISA, S. | 12301020383 | M621107 | 621107 | 63254-7 |
| IgG Disialo. GD1b | 12301000732 | MDISAG | 4416 | 94868-7 |
| IgM Disialo. GD1b | 12301000733 | MDISAM | 4417 | 94870-3 |
| IgG Monos. GM1 | 12301000728 | MGM1G | 4412 | 63243-0 |
| IgM Monos. GM1 | 12301000729 | MGM1M | 4413 | 63247-1 |
| MAG IgM, S. | 4622 | 12301018709 | 607034 | 39087-2 |
| Neurofascin-155 IgG4, S. | 12301021342 | M614591 | 614591 | 100845-7 |
Ordering Guidance
Multiple neurological phenotype-specific autoimmune/paraneoplastic evaluations are available. For more information as well as phenotype-specific testing options, refer to Autoimmune Neurology Test Ordering Guide.
For a list of antibodies performed with each evaluation, see Autoimmune Neurology Antibody Matrix.
Specimen Required
Patient Preparation: For optimal antibody detection, specimen collection is recommended to occur before starting immunosuppressant medication or intravenous immunoglobulin (IVIg) treatment.
Supplies: Sarstedt Aliquot Tube, 5 mL (T914)
Collection Container/Tube:
Preferred: Red top
Acceptable: Serum gel
Submission Container/Tube: Plastic vial
Specimen Volume: 3 mL
Collection Instructions: Centrifuge and aliquot serum into a plastic vial.
Forms
If not ordering electronically, complete, print, and send a Neurology Specialty Testing Client Test Request (T732) with the specimen.
Useful For
Evaluating patients with a suspected immune-mediated demyelinating peripheral neuropathy
Profile Information
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| DMNI | Demyelinating Neuropathy Interp, S | No | Yes |
| CONCS | Contactin-1 IgG CBA, S | No | Yes |
| GQ1ES | GQ1b-IgG ELISA, S | Yes | Yes |
| IGG_D | IgG Disialo. GD1b | No | Yes |
| IGM_D | IgM Disialo. GD1b | No | Yes |
| IGG_M | IgG Monos. GM1 | No | Yes |
| IGM_M | IgM Monos. GM1 | No | Yes |
| MAGES | MAG IgM, S | Yes | Yes |
| NF4FS | Neurofascin-155 IgG4, S | No | Yes |
Reflex Tests
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| IGDTS | IgG Disialo GD1b Titer, S | No | No |
| IMDTS | IgM Disialo GD1b Titer, S | No | No |
| IGMTS | IgG Monos GM1 Titer, S | No | No |
| IMMTS | IgM Monos GM1 Titer, S | No | No |
Testing Algorithm
Screening tests are performed for IgG and IgM antibodies to GM1 and GD1b. If positive, the appropriate titer assay will be performed at an additional charge.
For more information see:
-Demyelinating Neuropathy Evaluation Algorithm.
-Acquired Neuropathy Diagnostic Algorithm
To assess the probability of your patient having chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) vs mimic disorders, see the Chronic Inflammatory Demyelinating Polyradiculoneuropathy (CIDP) calculator.
Method Name
DMNI: Technical Interpretation
CONCS: Cell-Binding Assay (CBA)
GQ1ES, IGG_D, IGM_D, IGG_M, IGM_M, IGDTS, IMDTS, IGMTS, IMMTS, MAGES: Enzyme-Linked Immunosorbent Assay (ELISA)
NF4FS: Flow Cytometry
Reporting Name
Demyelinating Neuropathy Ab Eval, SSpecimen Type
SerumSpecimen Minimum Volume
2 mL
Specimen Stability Information
| Specimen Type | Temperature | Time |
|---|---|---|
| Serum | Refrigerated (preferred) | 28 days |
| Frozen | 28 days | |
| Ambient | 72 hours |
Reject Due To
| Gross hemolysis | Reject |
| Gross lipemia | Reject |
| Gross icterus | Reject |
Reference Values
Contactin-1 IgG CBA: Negative
GQ1b-IgG ELISA: Negative
IgG Disialo. GD1b: Negative
IgM Disialo. GD1b: Negative
IgG Monos. GM1: Negative
IgM Monos. GM1: Negative
MAG IgM: <1500 Buhlmann titer unit
Neurofascin-155 IgG4: Negative
Reflex Information:
IgG Disialo GD1b Titer: <1:2000
IgM Disialo GD1b Titer: <1:2000
IgG Monos GD1b Titer: <1:2000
IgM Monos GD1b Titer: <1:4000
Day(s) Performed
Monday through Sunday
Report Available
5 to 8 daysSpecimen Retention Time
28 daysPerforming Laboratory
Mayo Clinic Laboratories in Rochester
Test Classification
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.CPT Code Information
83516 x5
83520
86255 x2
83520 x4 (if applicable)
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| DMNES | Demyelinating Neuropathy Ab Eval, S | 82455-7 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| 621107 | GQ1b-IgG ELISA, S | 63254-7 |
| 621104 | Demyelinating Neuropathy Interpretation, S | 69048-7 |
| 4416 | IgG Disialo. GD1b | 94868-7 |
| 4412 | IgG Monos. GM1 | 63243-0 |
| 4417 | IgM Disialo. GD1b | 94870-3 |
| 4413 | IgM Monos. GM1 | 63247-1 |
| 607034 | MAG IgM, S | 39087-2 |
| 614591 | Neurofascin-155 IgG4, S | 100845-7 |
| 616442 | Contactin-1 IgG CBA, S | 101448-9 |