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TEST ID CDS1 CNS Demyelinating Disease Evaluation, Serum

Reporting Name

CNS Demyelinating Disease Eval, S

Specimen Type

Serum


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.


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

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

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.

Day(s) Performed

Monday, Tuesday, Thursday

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

Report Available

7 to 10 days

Specimen Retention Time

28 days

Performing Laboratory

Mayo Clinic Laboratories in Rochester

CPT Code Information

86053

86363

86053-Titer (if appropriate)

86363-Titer (if appropriate)

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

Highlights

Myelin oligodendrocyte glycoprotein (MOG)-IgG with a neuromyelitis optica spectrum disorder like phenotype is now recognized as a sensitive and specific diagnostic antibody biomarker of inflammatory demyelinating disorders (IDDs).

 

Approximately 80% of patients fulfilling 2006 Wingerchuk criteria for neuromyelitis optica are seropositive for aquaporin-4-IgG. Of the remaining 20%, one-third harbor MOG-IgG. Seropositivity predicts a relapsing phenotype and warrants immunosuppressive therapy. Patients only rarely harbor both antibodies.

 

There is currently no biomarker specific for MS (multiple sclerosis). Patients seropositive for MOG-IgG are commonly misdiagnosed as MS. Detection of MOG-IgG implies an inflammatory demyelinating disorder distinct from MS. MS therapies may worsen MOG-IgG associated IDDs, so correct diagnosis is important.

 

Seropositivity for MOG-IgG, in NMOSD like disorders, including optic neuritis, transverse myelitis, and acute disseminated encephalomyelitis, predicts relapse and warrants consideration for maintenance immunosuppression.

 

Seropositivity for MOG-IgG in the setting of a severe relapse of central nervous system demyelination warrants aggressive therapy with intravenous methylprednisolone or plasmapheresis.

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