Targeted antibody analysis  

Improved specificity for clinically actionable results

Patients with axonal autoimmune neuropathies, which result when peripheral nerve axons sustain damage, can have symmetric or asymmetric involvements of the extremities, trunk, and head, including extraocular muscles. Subacute onsets and asymmetric involvements more commonly indicate inflammatory or immune causes rather than inherited or metabolic forms. Other parts of the nervous system may also be affected based on the specific inflammatory or immune-mediated causes. Paraneoplastic involvements are mainly axonal in nature.

Because of the overlap of clinical symptoms, we recommend a panel-based approach rather than individual antibody testing. Our targeted axonal panel evaluates specific antibodies associated with autoimmune or paraneoplastic neuropathies.

When to consider testing

There are certain important clinical characteristics associated with the antibodies offered in this panel. The managing physician should consider ordering this test if the patient has one of the following clinical features:

  • Non-length-dependent or asymmetrical axonal neuropathies resembling either sensory neuronopathy, polyradiculoneuropathy, or another particular neuropathy
  • Progressive neuropathies with refractory pain or weight loss where an autoimmune or paraneoplastic etiology is suspected
  • Inflammatory CSF with an MRI demonstrating contrast enhancement of roots or nerves
  • Subacute axonal neuropathy with co-existing autonomic dysfunction or CNS involvement
  • Diffuse myokymia, cramp fasciculation syndromes, or neuromyotonia
  • Neuropathy developed as an immune-related adverse event of immune checkpoint inhibitors

Key testing

AIAES | Axonal Neuropathy, Autoimmune/Paraneoplastic Evaluation, Serum

Phenotypic evaluations

Our autoimmune axonal neuropathy evaluation is part of an evolving approach to testing for autoimmune neurological disorders using phenotypic-specific evaluations that include multiple antibodies known for their disease association.

A Test in Focus

Divyanshu Dubey, M.B.B.S., explains Mayo Clinic Laboratories' phenotypic testing approach for autoimmune axonal neuropathy. The comprehensive, serologic panel detects for antibodies with clinical relevance to the disease to provide clarity on etiology, prognosis, and treatment choices.

Learn more

Learn more about how to order this evaluation at your institution.

Resources

  1. Paraneoplastic and oncologic profiles of patients seropositive for type 1 antineuronal nuclear autoantibodies
  2. Autoimmune CRMP5 neuropathy phenotype and outcome defined from 105 cases
  3. Amphiphysin-IgG autoimmune neuropathy: A recognizable clinicopathologic syndrome
  4. Paraneoplastic encephalomyelopathies: pathology and mechanisms
  5. Expanded phenotypes and outcomes among 256 LGI1/CASPR2-IgG-positive patients