Autoimmune Myelopathy Evaluation [A Test in Focus]
Patients with autoimmune myelopathy present with subacute onset and rapid progression of spinal cord symptoms (weakness, gait difficulties, loss of sensation, neuropathic pain, and bowel and bladder dysfunction). An autoimmune myelopathy evaluation of serum and spinal fluid can assist in the diagnosis and aid distinction from other causes of myelopathy (multiple sclerosis, sarcoidosis, and vascular disease). Early diagnosis may assist in diagnosis of occult cancer, prompt initiation of immune therapies, or both.
Andrew McKeon, M.B., B.Ch., M.D., gives an overview of this new test available through Mayo Clinic Laboratories. He discusses when this testing should be ordered, how this testing improves upon previous testing approaches, what clinical action can be taken due to the results of this testing.
- Myelopathy, Autoimmune Evaluation, Spinal Fluid (Mayo ID: MAC1)
- Myelopathy, Autoimmune Evaluation, Serum (Mayo ID: MAS1)
When to Order
Consider autoimmune testing for patients presenting with spinal cord symptoms and one or more of the following:
- Rapid onset and progression
- Fluctuating course
- Autoimmune stigmata (e.g., physical signs or personal/family history of diabetes, thyroid disorder, vitiligo, prematurely gray hair, myasthenia gravis, rheumatoid arthritis, systemic lupus erythematosus)
- History of cancer
- Smoking history (20+ pack years) or other cancer risk factors
- Inflammatory cerebrospinal fluid
- Neuroimaging atypical for degenerative etiology
- Prior treatment with immune checkpoint inhibitors