Mayo Clinic Laboratories utilizes a comprehensive, phenotypic testing approach to evaluate for antibodies associated with autoimmune axonal neuropathy. In this "Test in Focus" episode of the "Answers From the Lab" podcast, Divyanshu Dubey, M.B.B.S., discusses the serological panel, which uses multiple methodologies to detect for nine distinct antibodies.

“All of the antibodies included in this panel are of significant relevance to patients with neuropathy,” Dr. Dubey says. “They not only provide information about the underlying etiology of neuropathy, they also point us towards if there’s an underlying cancer. They help us with having discussions with patients about the natural history of the disease and coming up with the best treatment regimen.”

The phenotype-specific approach to antibody evaluation is an improvement on previous approaches.  All relevant antibodies are included, not just those associated with cancer, and an improved methodology for several important tests helps improve specificity.

“We are adapting our evaluations to the growing science behind antibody reporting, discovery, and utilization,” Dr. Dubey says. “We are trying to make sure that if a patient is presenting with one particular syndrome or predominant neurological phenotype, we are covering all potential autoantibodies that are paraneoplastic or autoimmune."

Listen to learn more about how comprehensive testing for autoimmune axonal neuropathies can provide clarity on a complicated condition.

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Testing

AIAES   | Autoimmune Axonal Evaluation, Serum

Useful information

• Evaluation of patients who present with a subacute neurological disorder of undetermined etiology, especially those with known risk factors for cancer.
• Directing a focused search for cancer
• Investigating neurological symptoms that appear in the course of, or after, cancer therapy, and are not explainable by metastasis.
• Differentiating autoimmune neuropathies from neurotoxic effects of chemotherapy.
• Detecting early evidence of cancer recurrence in previously seropositive patients.

Specimen requirements

Patient Preparation:

1. For optimal antibody detection, specimen collection is recommended prior to initiation of immunosuppressant medication or intravenous immunoglobulin (IVIg) treatment.
2. 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.

Container/Tube:

Preferred: Red top

Acceptable: Serum gel

Specimen Volume: 4 mL

Performance information

• Analytic time: 5 to 10 days
• Day(s) and time(s) performed: AGN1S, AMPHS, AMPIS, ANN1S, ANN2S, ANN3S, CRMS, DPPTS, GABIS, GFATS, GL1TS, NMDIS, PCAB2, PCABP: Monday through Sunday
• CS2CS, AMPCS, GABGS, LG1CS, NMDCS: Monday through Thursday, Sunday
• DPPCS, GL1CS: Wednesday
• GFACS: Monday, Wednesday
• AGNBS, AMIBS, AN1BS, AN2BS, PC1BS, PCTBS: Monday through Friday
• CRMWS: Monday, Wednesday, Friday

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