Posted Date
Effective Date
Update Type New Tests

NEW TESTS

 

Test Code

Test Name

MAC1

Autoimmune Myelopathy Eval, CSF

MAS1

Autoimmune Myelopathy Eval, S

MDC2

Movement Autoimmune Eval, CSF

MDS2

Movement Autoimmune Eval, S

PCDEC

Peds Autoimmune CNS Eval, CSF

PCDES

Peds Autoimmune CNS Eval, S

AIAES

Autoimmune Axonal Eval, S

 

OBSOLETE TESTS

Test Code

Test Name

DMS2

Dementia Autoimmune Evaluation, Serum

DMC2

Dementia, Autoimmune Evaluation, CSF

EPS2

Epilepsy Autoimmune Evaluation, Serum

EPC2

Epilepsy, Autoimmune Evaluation, CSF

PAVL

Paraneoplastic Autoantibody Evaluation

 

Effective December 1, 2021, MLabs will build new tests to follow the Michigan Medicine laboratory formulary algorithm and inactivate the test options that are not recommended due to very low diagnostic yield. 

 

Michigan Medicine Pathology and Neurology Departments recently led an effort to better utilize neurology-related paraneoplastic antibody testing, which is sent to Mayo Clinic Laboratories.  The team developed test recommendations to guide best ordering practices.  MLabs now offers autoantibody screening panels that align with various neurologic paraneoplastic syndromes (e.g., movement disorders, myelitis, peripheral neuropathy, etc.) as detailed below:

 

Test Recommendations for Neurologic Autoimmune and Paraneoplastic Syndromes

 

  1. Encephalitis (limbic, brainstem, autoimmune epilepsy)

Reconsider if patient does not have one of the following acute/subacute presentation, focal neurologic deficits, new seizures, CSF abnormalities, supportive imaging. If high pre-test probability, it is likely appropriate to order both serum and CSF testing.

  • Encephalopathy, Autoimmune Evaluation, Serum (ENS2)
  • Encephalopathy, Autoimmune Evaluation, Spinal Fluid (ENC2)

 

  1. Movement disorders (including ataxia, opsoclonus/myoclonus, chorea, etc.)
    • Movement Disorder, Autoimmune Evaluation, Serum (MDS2)
    • Movement Disorder, Autoimmune Evaluation, Spinal Fluid (MDC2)

 

  1. Myelitis and/or optic neuritis (NMO spectrum disorders)
    • CNS Demyelinating Evaluation, Serum (CDS1)

 

  1. Autoimmune peripheral neuropathy (neuronopathy, polyradiculopathy)
    • Autoimmune Axonal Evaluation, Serum (AIAES)

 

  1. Autoimmune autonomic neuropathy (acute/subacute presentation)
    • Autoimmune Dysautonomia Evaluation, Serum (DYS2)

 

  1. Myasthenia gravis
    • Myasthenia Gravis Evaluation with MuSK Reflex, Serum (MGMR)

 

  1. LEMS
    • Voltage-Gated Calcium Channel (VGCC) Antibody (AVGCC) (sent to ARUP Laboratories)

 

The following panels are seldom appropriate and should be used in limited circumstances:

  • Pediatric Autoimmune Central Nervous System Disorders Evaluation, Serum (PCDES)
  • Pediatric Autoimmune Central Nervous System Disorders Evaluation, Spinal Fluid (PCDEC)
  • Autoimmune Myelopathy Evaluation, Serum (MAS1)
  • Autoimmune Myelopathy Evaluation, Spinal Fluid (MAC1)

 

The following panels are not recommended:

  • Dementia, Autoimmune Evaluation, Serum (DMS2), recommend ENS2 instead
  • Dementia, Autoimmune Evaluation, Spinal Fluid (DMC2), recommend ENC2 instead
  • Epilepsy, Autoimmune Evaluation, Serum (EPS2), recommend ENS2 instead
  • Epilepsy, Autoimmune Evaluation, Spinal Fluid (EPC2), recommend ENC2 instead
  • Paraneoplastic, Autoantibody Evaluation, Serum (PAVAL)

 

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