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Test Code GID2 Gastrointestinal Dysmotility, Autoimmune/Paraneoplastic Evaluation, Serum

Additional Codes

Internal / External / Beaker: LAB5196


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.

 

When more than one evaluation is ordered on the same order number the duplicate will be canceled.

 

For a list of antibodies performed with each evaluation, see Autoimmune Neurology Antibody Matrix.

 

This test should not be requested in patients who have recently received radioisotopes, therapeutically or diagnostically, because of potential assay interference. The specific waiting period before specimen collection will depend on the isotope administered, the dose given, and the clearance rate in the individual patient. Specimens will be screened for radioactivity prior to analysis. Radioactive specimens received in the laboratory will be held 1 week and assayed if sufficiently decayed or canceled if radioactivity remains.



Necessary Information


Provide the following information:

-Relevant clinical information

-Ordering provider name, phone number, mailing address, and e-mail address



Specimen Required


Patient Preparation: For optimal antibody detection, specimen collection is recommended prior to initiation of 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: 4 mL

Collection Instructions: Centrifuge and aliquot serum into a plastic vial.


Secondary ID

92120

Useful For

Investigating unexplained weight loss, early satiety, anorexia, nausea, vomiting, constipation, or diarrhea in a patient with a past or family history of cancer or autoimmunity

 

Directing a focused search for cancer

 

Investigating gastrointestinal symptoms that appear in the course or wake of cancer therapy, not explainable by recurrent cancer, metastasis, or therapy; detection of autoantibodies on this profile helps differentiate autoimmune gastrointestinal dysmotility from the effects of chemotherapy

 

Detecting early evidence of cancer recurrence in previously seropositive patients who have a rising titer of 1 or more autoantibodies

Profile Information

Test ID Reporting Name Available Separately Always Performed
AGIDI GI Dysmotility, Interpretation, S No Yes
GANG AChR Ganglionic Neuronal Ab, S No Yes
ANN1S Anti-Neuronal Nuclear Ab, Type 1 No Yes
APBIS AP3B2 IFA, S No Yes
CS2CS CASPR2-IgG CBA, S No Yes
CRMS CRMP-5-IgG, S No Yes
DPPCS DPPX Ab CBA, S Yes Yes
LG1CS LGI1-IgG CBA, S No Yes
PCAB2 Purkinje Cell Cytoplasmic Ab Type 2 No Yes

Reflex Tests

Test ID Reporting Name Available Separately Always Performed
AN1BS ANNA-1 Immunoblot, S No No
AN2BS ANNA-2 Immunoblot, S No No
CRMWS CRMP-5-IgG Western Blot, S Yes No
DPPTS DPPX Ab IFA Titer, S No No
AN1TS ANNA-1 Titer, S No No
APBCS AP3B2 CBA, S No No
APBTS AP3B2 IFA Titer, S No No
CRMTS CRMP-5-IgG Titer, S No No
PC2TS PCA-2 Titer, S No No

Testing Algorithm

If client requests or if the immunofluorescence assay (IFA) patterns suggest collapsin response-mediator protein-5 (CRMP-5)-IgG, then the CRMP-5-IgG IFA titer and CRMP-5-IgG Western blot will be performed at an additional charge.

 

If the IFA pattern suggests antineuronal nuclear antibody (ANNA)-1, then the ANNA-1 immunoblot, ANNA-1 titer, and ANNA-2 immunoblot will be performed at an additional charge.

 

If the IFA pattern suggests AP3B2 adaptor protein 3 beta2) antibodies, then the AP3B22 cell binding assay (CBA) and AP3B22 titer will be performed at an additional charge.

 

If the IFA pattern suggests PCA-2 antibody, then the PCA-2 IFA titer will be performed at an additional charge.

 

If dipeptidyl-peptidase-like protein-6 antibody (DPPX) antibody CBA result is positive, then the DPPX titer will be performed at an additional charge.

 

For more information see Autoimmune/Paraneoplastic Gastrointestinal Dysmotility Evaluation Algorithm.

Method Name

ANN1S, AN1TS, APBIS, APBTS, DPPTS, CRMS, CRMTS, PCAB2, PC2TS: Indirect Immunofluorescence Assay (IFA)

 

APBCS, CS2CS, LG1CS, DPPCS: Cell Binding Assay (CBA)

 

CRMWS: Western Blot (WB)

 

AN1BS, AN2BS: Immunoblot (IB)

 

GANG: Radioimmunoassay (RIA)

Reporting Name

GI Dysmotility, Autoimm/Paraneo, 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

Test ID

Reporting Name

Methodology*

Reference Value

AGIDI

GI Dysmotility, Interpretation, S

Medical interpretation

Interpretive report

GANG

AChR Ganglionic Neuronal Ab, S

RIA

≤0.02 nmol/L

ANN1S

Anti-Neuronal Nuclear Ab, Type 1

IFA

Negative

APBIS

AP3B2 IFA, S

IFA

Negative

CS2CS

CASPR2-IgG CBA, S

CBA

Negative

CRMS

CRMP-5-IgG, S

IFA

Negative

DPPCS

DPPX Ab CBA, S

CBA

Negative

LG1CS

LGI1-IgG CBA, S

CBA

Negative

PCAB2

Purkinje Cell Cytoplasmic Ab Type 2

IFA

Negative

Reflex Information:

Test ID

Reporting Name

Methodology*

Reference Value

AN1BS

ANNA-1 Immunoblot, S

IB

Negative

AN1TS

ANNA-1 Titer, S

IFA

<1:240

AN2BS

ANNA-2 Immunoblot, S

IB

Negative

APBCS

AP3B2 CBA, S

CBA

Negative

APBTS

AP3B2 IFA Titer, S

IFA

<1:240

CRMTS

CRMP-5-IgG Titer, S

IFA

<1:240

CRMWS

CRMP-5-IgG Western Blot, S

WB

Negative

DPPTS

DPPX Ab IFA Titer, S

IFA

<1:240

PC2TS

PCA-2 Titer, S

IFA

<1:240

 

*Methodology abbreviations used:

Immunofluorescence assay (IFA)

Cell-binding assay (CBA)

Western blot (WB)

Radioimmunoassay (RIA)

Immunoblot (IB)

 

Neuron-restricted patterns of IgG staining that do not fulfill criteria for ANNA-1, CRMP-5-IgG, or PCA-2 may be reported as "unclassified anti-neuronal IgG." Complex patterns that include nonneuronal elements may be reported as "uninterpretable."

 

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 for 4 weeks). This supplemental testing is recommended in cases of chorea, vision loss, cranial neuropathy, and myelopathy. Call 1-800-533-1710 to request CRMP-5 Western blot.

Report Available

8 to 12 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

83519

86255 x 7

84182 AN1BS (if appropriate)

86256 AN1TS (if appropriate)

84182 AN2BS (if appropriate)

86255 APBCS (if appropriate)

86256 APBTS (if appropriate)

86256 CRMTS (if appropriate)

84182 CRMWS (if appropriate)

86255 DPPCS (if appropriate)

86256 DPPTS (if appropriate)

86256 PC2TS (if appropriate)

LOINC Code Information

Test ID Test Order Name Order LOINC Value
GID2 GI Dysmotility, Autoimm/Paraneo, S 97557-3

 

Result ID Test Result Name Result LOINC Value
34269 GI Dysmotility, Interpretation, S 69048-7
80150 ANNA-1, S 33615-6
83077 CRMP-5-IgG, S 72504-4
84321 AChR Ganglionic Neuronal Ab, S 94694-7
83138 PCA-2, S 84925-7
64279 LGI1-IgG CBA, S 94287-0
64281 CASPR2-IgG CBA, S 94285-4
64933 DPPX Ab CBA, S 94676-4
615863 AP3B2 IFA, S 101907-4
618899 IFA Notes 48767-8

Forms

If not ordering electronically, complete, print, and send Gastroenterology and Hepatology Test Request (T728) with the specimen