Unique pediatric evaluation targets relevant autoimmune/CNS antibodies


Test in Focus

Andrew McKeon, M.B., B.Ch., M.D., explains how Mayo Clinic Laboratories' pediatric autoimmune/CNS testing better guides the diagnosis and treatment of autoimmune neurological diseases in children. The tailored evaluation covers only autoantibodies relevant to pediatric presentations of the diseases.

Autoimmune neurologic diseases are increasingly recognized in children — but standard testing panels include autoantibodies that aren't relevant for pediatric patients. In this "Test in Focus" episode of the "Answers From the Lab" podcast, Andrew McKeon, M.B., B.Ch., M.D., explains how Mayo Clinic Laboratories' unique, tailored pediatric panel avoids over-testing while guiding diagnosis and treatment.

"The number of autoantibodies discovered for autoimmune neurologic disease has grown quite a lot. But many of them have not been reported in children or teenagers," Dr. McKeon says. "The pediatric autoimmune/CNS evaluation is an opportunity to order tailored profiles for the pediatric population. Using an adult panel would be ordering a number of tests that the patient doesn't need. We're trying to avoid misuse of tests."

The pediatric evaluation, which requires both serum and spinal fluid samples, is part of Mayo Clinic Laboratories' phenotype-specific approach. Decisions about which antibodies are included in the testing are based on Mayo Clinic physicians' experiences with patients.

"Autoimmune neurology is quite a complex field. It's in the interests of patients and doctors to order evaluations based on what is coming into the clinic," Dr. McKeon says. "That's why we elected to trim the evaluation down to biomarkers relevant for children."

Listen to learn more about Mayo Clinic Laboratories' unique pediatric autoimmune/CNS evaluation.

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Testing

Useful information

PCDEC | Pediatric Autoimmune Encephalopathy/CNS Disorder Evaluation, Spinal Fluid

Evaluating children with autoimmune central nervous system disorders using spinal fluid specimens.

PCDES | Pediatric Autoimmune CNS Disorders Evaluation, Serum

Evaluating children with autoimmune central nervous system disorders using serum specimens.

Specimen requirements

PCDEC | Pediatric Autoimmune Encephalopathy/CNS Disorder Evaluation, Spinal Fluid

  • Specimen Type: CSF
  • Specimen Volume: 4 mL
  • Container/Tube: Sterile vial

PCDES | Pediatric Autoimmune CNS Disorders Evaluation, Serum

  • Specimen Type: Serum
  • Specimen Volume: 4 mL
  • Submission Container/Tube: Plastic vial
    • Preferred: Red top
    • Acceptable: Serum gel

Patient Preparation:

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

Performance information

PCDEC | Pediatric Autoimmune Encephalopathy/CNS Disorder Evaluation, Spinal Fluid

Analytic time: 8 to 11 days

Days performed: Profile tests: Monday through Sunday; Reflex tests: Varies

PCDES | Pediatric Autoimmune CNS Disorders Evaluation, Serum

Analytic time: 10 to 13 days

Days performed: Profile tests: Monday through Sunday; Reflex tests: Varies

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Barbara J. Toman (@barbaratoman)

Barbara J. Toman

Barbara J. Toman is a Senior Communications Specialist at Mayo Clinic Laboratories. She is also the science writer for Mayo’s Neurosciences Update newsletter, which helps referring physicians to stay informed about Mayo’s treatment and research. Barbara has worked at Mayo Clinic since 2007. She enjoys international travel and cooking.