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HelpTest Code ENC2M Encephalopathy, Autoimmune/Paraneoplastic Evaluation, Spinal Fluid
Additional Codes
| EPIC EAP | Mayo |
| LAB7893 | ENC2 |
Ordering Guidance
Multiple neurological phenotype-specific autoimmune/paraneoplastic evaluations are available. For more information as well as phenotype-specific testing options, see Autoimmune Neurology Test Ordering Guide.
When more than one evaluation is ordered on the same order number, the duplicate test will be canceled.
For a list of antibodies performed with each evaluation, see Autoimmune Neurology Antibody Matrix.
This test is intended to be ordered for adult patients. If this test is ordered for a patient younger than 18 years, it will be canceled and automatically reordered by the laboratory as PCDEC / Pediatric Autoimmune Encephalopathy/CNS Disorder Evaluation, Spinal Fluid. The pediatric autoimmune CNS disorders 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.
Necessary Information
Provide the following information:
-Relevant clinical information
-Ordering healthcare professional's name, phone number, mailing address, and e-mail address
Specimen Required
Container/Tube: Sterile vial
Preferred: Collection vial number 1
Acceptable: Any collection vial
Specimen Volume: 4 mL
Forms
If not ordering electronically, complete, print, and send 1 of the following with the specimen:
-Neurology Specialty Testing Client Test Request (T732)
-General Test Request (T239)
-Microbiology Test Request (T244)
Useful For
Evaluating new onset encephalopathy (noninfectious or metabolic) comprising confusional states, psychosis, delirium, memory loss, hallucinations, movement disorders, sensory or motor complaints, seizures, dyssomnias, ataxias, nausea, vomiting, inappropriate antidiuresis, coma, dysautonomias, or hypoventilation using spinal fluid specimens
The following accompaniments should increase of suspicion for autoimmune encephalopathy:
-Headache
-Autoimmune stigmata (personal or family history or signs of diabetes mellitus, thyroid disorder, vitiligo, poliosis [premature graying], myasthenia gravis, rheumatoid arthritis, systemic lupus erythematosus)
-History of cancer
-Smoking history (20 or more pack-years) or other cancer risk factors
-Inflammatory cerebrospinal fluid (or isolated protein elevation)
-Neuroimaging signs suggesting inflammation
Evaluating limbic encephalitis (noninfectious)
Directing a focused search for cancer
Investigating encephalopathy appearing during or after cancer therapy and not explainable by metastasis or drug effect
Profile Information
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| AEECI | Encephalopathy, Interpretation, CSF | No | Yes |
| AMPCC | AMPA-R Ab CBA, CSF | No | Yes |
| AMPHC | Amphiphysin Ab, CSF | No | Yes |
| AGN1C | Anti-Glial Nuclear Ab, Type 1 | No | Yes |
| ANN1C | Anti-Neuronal Nuclear Ab, Type 1 | No | Yes |
| ANN2C | Anti-Neuronal Nuclear Ab, Type 2 | No | Yes |
| ANN3C | Anti-Neuronal Nuclear Ab, Type 3 | No | Yes |
| CS2CC | CASPR2-IgG CBA, CSF | No | Yes |
| CRMC | CRMP-5-IgG, CSF | No | Yes |
| DPPCC | DPPX Ab CBA, CSF | No | Yes |
| GABCC | GABA-B-R Ab CBA, CSF | No | Yes |
| GD65C | GAD65 Ab Assay, CSF | Yes | Yes |
| GFAIC | GFAP IFA, CSF | No | Yes |
| GL1IC | mGluR1 Ab IFA, CSF | No | Yes |
| IG5CC | IgLON5 CBA, CSF | No | Yes |
| LG1CC | LGI1-IgG CBA, CSF | No | Yes |
| NCDIC | Neurochondrin IFA, CSF | No | Yes |
| NIFIC | NIF IFA, CSF | No | Yes |
| NMDCC | NMDA-R Ab CBA, CSF | No | Yes |
| PCTRC | Purkinje Cell Cytoplasmc Ab Type Tr | No | Yes |
| PCA1C | Purkinje Cell Cytoplasmic Ab Type 1 | No | Yes |
| PCA2C | Purkinje Cell Cytoplasmic Ab Type 2 | No | Yes |
| PDEIC | PDE10A Ab IFA, CSF | No | Yes |
| SP7IC | Septin-7 IFA, CSF | No | Yes |
| T46IC | TRIM46 Ab IFA, CSF | No | Yes |
Reflex Tests
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| AGNBC | AGNA-1 Immunoblot, CSF | No | No |
| AINCC | Alpha Internexin CBA, CSF | No | No |
| AMPIC | AMPA-R Ab IF Titer Assay, CSF | No | No |
| AMIBC | Amphiphysin Immunoblot, CSF | No | No |
| AN1BC | ANNA-1 Immunoblot, CSF | No | No |
| AN2BC | ANNA-2 Immunoblot, CSF | No | No |
| CRMWC | CRMP-5-IgG Western Blot, CSF | Yes | No |
| DPPTC | DPPX Ab IFA Titer, CSF | No | No |
| GABIC | GABA-B-R Ab IF Titer Assay, CSF | No | No |
| GFACC | GFAP CBA, CSF | No | No |
| GFATC | GFAP IFA Titer, CSF | No | No |
| IG5TC | IgLON5 IFA Titer, CSF | No | No |
| GL1CC | mGluR1 Ab CBA, CSF | No | No |
| GL1TC | mGluR1 Ab IFA Titer, CSF | No | No |
| NFHCC | NIF Heavy Chain CBA, CSF | No | No |
| NIFTC | NIF IFA Titer, CSF | No | No |
| NFLCC | NIF Light Chain CBA, CSF | No | No |
| NMDIC | NMDA-R Ab IF Titer Assay, CSF | No | No |
| PC1BC | PCA-1 Immunoblot, CSF | No | No |
| PCTBC | PCA-Tr Immunoblot, CSF | No | No |
| AGNTC | AGNA-1 Titer, CSF | No | No |
| AN1TC | ANNA-1 Titer, CSF | No | No |
| AN2TC | ANNA-2 Titer, CSF | No | No |
| AN3TC | ANNA-3 Titer, CSF | No | No |
| APHTC | Amphiphysin Ab Titer, CSF | No | No |
| CRMTC | CRMP-5-IgG Titer, CSF | No | No |
| NCDCC | Neurochondrin CBA, CSF | No | No |
| NCDTC | Neurochondrin IFA Titer, CSF | No | No |
| PC1TC | PCA-1 Titer, CSF | No | No |
| PC2TC | PCA-2 Titer, CSF | No | No |
| PCTTC | PCA-Tr Titer, CSF | No | No |
| PDETC | PDE10A Ab IFA Titer, CSF | No | No |
| SP7CC | Septin-7 CBA, CSF | No | No |
| SP7TC | Septin-7 IFA Titer, CSF | No | No |
| T46CC | TRIM46 Ab CBA, CSF | No | No |
| T46TC | TRIM46 Ab IFA Titer, CSF | No | No |
Special Instructions
Method Name
AEECI: Medical Interpretation
AGN1C, AGNTC, AMPIC, AMPHC, APHTC, ANN1C, AN1TC, ANN2C, AN2TC, ANN3C, AN3TC, CRMTC, CRMC, DPPTC, GABIC, GFAIC, GFATC, IG5TC, GL1IC, GL1TC, NCDIC, NCDTC, NIFIC, NIFTC, NMDIC, PCA1C, PC1TC, PCA2C, PC2TC, PCTRC, PCTTC, PDEIC, PDETC, SP7IC, SP7TC, T46IC, T26TC: Indirect Immunofluorescence Assay (IFA)
AMPCC, CS2CC, DPPCC, GABCC, GFACC, IG5CC, LG1CC, GL1CC, NCDCC, AINCC, NFLCC, NFHCC, NMDCC, SP7CC, T46CC: Cell Binding Assay (CBA)
CRMWC: Western Blot (WB)
AGNBC, AMIBC, AN1BC, AN2BC, PC1BC, PCTBC: Immunoblot (IB)
GD65C: Radioimmunoassay (RIA)
Reporting Name
Enceph, Autoimm/Paraneo, CSFSpecimen Type
CSFSpecimen Minimum Volume
2 mL
Specimen Stability Information
| Specimen Type | Temperature | Time |
|---|---|---|
| CSF | Refrigerated (preferred) | 28 days |
| Frozen | 28 days | |
| Ambient | 72 hours |
Reject Due To
| Gross hemolysis | Reject |
| Gross lipemia | Reject |
| Gross icterus | Reject |
Day(s) Performed
Profile tests: Monday through Sunday; Reflex tests: Varies
Report Available
8 to 12 daysPerforming Laboratory
Mayo Clinic Laboratories in Rochester
Test Classification
This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.CPT Code Information
86255 x23
86341 x1
84182 AGNBC (if appropriate)
86256 AGNTC (if appropriate)
86255 AINCC (if appropriate)
86256 AMPIC (if appropriate)
84182 AMIBC (if appropriate)
84182 AN1BC (if appropriate)
86256 AN1TC (if appropriate)
84182 AN2BC (if appropriate)
86256 AN2TC (if appropriate)
86256 AN3TC (if appropriate)
86256 APHTC (if appropriate)
86256 CRMTC (if appropriate)
84182 CRMWC (if appropriate)
86256 DPPTC (if appropriate)
86256 GABIC (if appropriate)
86255 GFACC (if appropriate)
86256 GFATC (if appropriate)
86256 IG5TC (if appropriate)
86255 GL1CC (if appropriate)
86256 GL1TC (if appropriate)
86255 NCDCC (if appropriate)
86256 NCDTC (if appropriate)
86255 NFHCC (if appropriate)
86256 NIFTC (if appropriate)
86255 NFLCC (if appropriate)
86256 NMDIC (if appropriate)
84182 PC1BC (if appropriate)
86256 PC1TC (if appropriate)
86256 PC2TC (if appropriate)
84182 PCTBC (if appropriate)
86256 PCTTC (if appropriate)
86256 PDETC (if appropriate)
86255 SP7CC (if appropriate)
86256 SP7TC (if appropriate)
86255 T46CC (if appropriate)
86256 T46TC (if appropriate)
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| ENC2 | Enceph, Autoimm/Paraneo, CSF | 94708-5 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| 61513 | NMDA-R Ab CBA, CSF | 93502-3 |
| 61514 | AMPA-R Ab CBA, CSF | 93491-9 |
| 61515 | GABA-B-R Ab CBA, CSF | 93426-5 |
| 34256 | Encephalopathy, Interpretation, CSF | 69048-7 |
| 89079 | AGNA-1, CSF | 90827-7 |
| 5906 | Amphiphysin Ab, CSF | 90815-2 |
| 3852 | ANNA-1, CSF | 44768-0 |
| 7472 | ANNA-2, CSF | 56959-0 |
| 21633 | ANNA-3, CSF | 90836-8 |
| 21650 | CRMP-5-IgG, CSF | 63216-6 |
| 3988 | PCA-1, CSF | 90841-8 |
| 21632 | PCA-2, CSF | 90843-4 |
| 21631 | PCA-Tr, CSF | 90845-9 |
| 21702 | GAD65 Ab Assay, CSF | 94359-7 |
| 64280 | LGI1-IgG CBA, CSF | 94288-8 |
| 64282 | CASPR2-IgG CBA, CSF | 94286-2 |
| 64927 | mGluR1 Ab IFA, CSF | 94361-3 |
| 64934 | DPPX Ab CBA, CSF | 94283-9 |
| 605156 | GFAP IFA, CSF | 94360-5 |
| 606965 | NIF IFA, CSF | 96490-8 |
| 606951 | IgLON5 CBA, CSF | 96481-7 |
| 615866 | Neurochondrin IFA, CSF | 101451-3 |
| 615874 | Septin-7 IFA, CSF | 101464-6 |
| 620067 | PDE10A Ab IFA, CSF | 103842-1 |
| 616446 | TRIM46 Ab IFA, CSF | 103843-9 |
| 618895 | IFA Notes | 48767-8 |