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Test Code LAB0001204 CNS Demyelinating Disease Evaluation, Serum

Additional Codes

Mayo Test ID
CDS1


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 before initiation of immunosuppressant medication.

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

Diagnosis of inflammatory demyelinating diseases (IDDs) with similar phenotype to neuromyelitis optica spectrum disorder (NMOSD), including optic neuritis (single or bilateral) and transverse myelitis

 

Diagnosis of autoimmune myelin oligodendrocyte glycoprotein-opathy

 

Diagnosis of neuromyelitis optica

 

Distinguishing NMOSD, acute disseminated encephalomyelitis (ADEM), optic neuritis, and transverse myelitis from multiple sclerosis early in the course of disease

 

Diagnosis of ADEM

 

Prediction of a relapsing disease course

Profile Information

Test ID Reporting Name Available Separately Always Performed
CSI1 CNS Demyelinating Disease Interp, S No Yes
NMOFS NMO/AQP4 FACS, S Yes Yes
MOGFS MOG FACS, S Yes Yes

Reflex Tests

Test ID Reporting Name Available Separately Always Performed
NMOTS NMO/AQP4 FACS Titer, S No No
MOGTS MOG FACS Titer, S No No

Testing Algorithm

When the results of this assay require further evaluation of myelin oligodendrocyte glycoprotein (MOG-IgG1), the MOG-IgG1 titer will be performed at an additional charge.

 

When the results of this assay require further evaluation of neuromyelitis optica (NMO)/Aquaporin-4-IgG, the neuromyelitis optica (NMO)/aquaporin-4-IgG titer will be performed at an additional charge.

 

For more information, see the following algorithms:

-Pediatric Autoimmune Central Nervous System Demyelinating Disease Diagnostic Algorithm

-Central Nervous System Demyelinating Disease Diagnostic Algorithm

Method Name

Flow Cytometry

Reporting Name

CNS Demyelinating Disease Eval, S

Specimen Type

Serum

Specimen Minimum Volume

2 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
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

MYELIN OLIGODENDROCYTE GLYCOPROTEIN FLORESCENCE-ACTIVATED CELL SORTING(FACS)

Negative

Reference values apply to all ages.

 

NEUROMYELITIS OPTICA/AQUAPORIN-4-IgG FACS

Negative

Reference values apply to all ages.

Interpretation

A positive value for aquaporin-4 (AQP4)-IgG is consistent with an autoimmune astrocytopathy/neuromyelitis optica spectrum disorder (NMOSD) and justifies initiation of appropriate immunosuppressive therapy at the earliest possible time. This allows early initiation and maintenance of optimal therapy. Recommend follow-up in 3 to 6 months if NMOSD is suspected.

 

A positive value for myelin oligodendrocyte glycoprotein (MOG)-IgG is consistent with a neuromyelitis optica-like phenotype and in the setting of acute disseminated encephalomyelitis, optic neuritis and transverse myelitis,  indicates an autoimmune oligodendrogliopathy with potential for relapsing course. Identification of MOG-IgG allows distinction from multiple sclerosis (MS) and may justify initiation of appropriate immunosuppressive therapy (not MS disease-modifying agents) at the earliest possible time. This allows early initiation and maintenance of optimal therapy. Recommend follow-up in 6 to 12  months as persistence of MOG-IgG seropositivity predicts a relapsing course.

 

Detection of both antibodies is rare and unusual.

 

AQP4-IgG and MOG-IgG are not found in MS or healthy subjects.

Day(s) Performed

Monday, Tuesday, Thursday

Report Available

7 to 10 days

Specimen Retention Time

28 days

Performing 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

86053

86363

86053-Titer (if appropriate)

86363-Titer (if appropriate)

LOINC Code Information

Test ID Test Order Name Order LOINC Value
CDS1 CNS Demyelinating Disease Eval, S 102085-8

 

Result ID Test Result Name Result LOINC Value
38324 NMO/AQP4 FACS, S 43638-6
65563 MOG FACS, S 90248-6
113625 CNS Demyelinating Disease Interp, S 69048-7