MCL

Mayo Clinic Laboratories is the only laboratory in the world to offer testing for a novel form of autoimmune meningoencephalomyelitis. Known as autoimmune glial fibrillary acidic protein (GFAP) astrocytopathy, the condition was identified by Mayo Clinic in 2016. The GFAP antibody test is offered as part of Mayo Clinic Laboratories’ encephalitis and myelopathy evaluations.

Rondell P. Graham, M.B.B.S., gives an overview of this 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.

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). 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.

In May 2019, Mayo Clinic Laboratories announced four new tests along with numerous reference value changes, obsolete tests, and algorithm changes.

Mayo Clinic Laboratories is one of the few laboratories in the country to offer two special sequencing-based tests for bacteria in its catalog. The first test is designed to help protect patients by investigating potential outbreaks of a single bacterial species or by identifying recurrent infections in an individual patient. The second has the ability to detect DNA of any bacteria to help identify the cause of an infection.

Blacklegged ticks (also known as deer ticks) are turning up more frequently in Minnesota, and so are the diseases they carry. Bobbi Pritt, a parasitologist in the Department of Laboratory Medicine and Pathology at Mayo Clinic in Rochester, Minnesota, weighs in on the issue.

Antibodies to aquaporin-4 and myelin oligodendrocyte glycoprotein (MOG) are recently described biomarkers seen in a subset of atypical optic neuritis which have revolutionized our understanding of the condition. In this “Hot Topic,” my colleague, Dr. John Chen, will review these advances and how they impact the clinical care of our patients with optic neuritis.

The standard test for the diagnosis of narcolepsy is the multiple sleep latency test (MSLT). The MSLT is a complex test to perform as well as to interpret. The orexin-A/hypocretin-1 test is a sensitive and specific alternative to the MSLT to diagnose type 1 narcolepsy.

The presence NTRK gene fusions is one of the eligibility requirements for the recently FDA-approved therapy Vitrakvi (larotrectinib), a therapy indicated in adult and pediatric patients with solid tumors regardless of the type of tumor. NTRK gene fusions have been described in many cancers at various frequencies including common cancers such as lung, thyroid, and colorectal cancers.

Joseph Yao, 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 other testing approaches, and what clinical action can be taken due to the results of this testing.

Neuro-oncology is a complex field undergoing rapid changes with the advancement and evolution of sophisticated genetic testing. Evidence continues to grow in support of broad molecular and cytogenetic analysis for patients with brain tumors.

The diagnosis of mitochondrial disease can be particularly challenging as the presentation can occur at any age, involve virtually any organ system, and be associated with widely varying severities. Due to the considerable overlap in the clinical phenotypes of various mitochondrial disorders, it is often difficult to distinguish these specific inherited disorders without genetic testing.

In April 2019, Mayo Clinic Laboratories announced nine new tests along with numerous reference value changes, obsolete tests, and algorithm changes.