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Test Code CRMWC Collapsin Response-Mediator Protein-5-IgG, Western Blot, Spinal Fluid

Useful For

Evaluation of cases of chorea, vision loss, cranial neuropathy and myelopathy

Method Name

Western Blot

Reporting Name

CRMP-5-IgG Western Blot, CSF

Specimen Type

CSF


Ordering Guidance


It is recommended an evaluation be ordered in conjunction with this testing if not previously performed. 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.



Additional Testing Requirements


 



Shipping Instructions


Send specimen refrigerated.



Necessary Information


Provide the following information:

-Relevant clinical information

-Ordering healthcare professional name, phone number, mailing address, and e-mail address



Specimen Required


Container/Tube: Sterile vial

Specimen Volume: 3 mL


Specimen Minimum Volume

2 mL

Specimen Stability Information

Specimen Type Temperature Time
CSF Refrigerated (preferred) 28 days
  Frozen  28 days
  Ambient  72 hours

Reference Values

Negative

Interpretation

A positive result confirms that a patient's subacute neurological disorder has an autoimmune basis and is likely to be associated with a small-cell lung carcinoma (SCLC) or thymoma, which may be occult.(1,2) A positive result has a predictive value of 90% for neoplasm (77% SCLC, 6% thymoma).(1) Seropositivity is found in approximately 3% of patients who have SCLC with limited metastasis without evidence of neurological autoimmunity.(6)

 

Clinical-serological correlations have not yet been established for children.

 

Western blot analysis is indicated when interfering nonorgan-specific or coexisting neuron-specific autoantibodies in serum or spinal fluid preclude unambiguous detection of CRMP-5-IgG by indirect immunofluorescence assay, or when the immunofluorescence assay is negative in a patient whose neurological presentation suggests a CRMP-5-IgG-related syndrome.

Clinical Reference

1. Yu Z, Kryzer TJ, Griesmann GE, et al. CRMP-5 neuronal autoantibody: marker of lung cancer and thymoma-related autoimmunity. Ann Neurol. 2001;49(2):146-154

2. Vernino S, Tuite P, Adler CH, et al. Paraneoplastic chorea associated with CRMP-5 neuronal antibody and lung carcinoma. Ann Neurol. 2002;51(5):625-630

3. Vernino S, Lennon VA. Autoantibody profiles and neurological correlations of thymoma. Clin Cancer Res. 2004;10(21):7270-7275

4. Galanis E, Frytak S, Rowland KM Jr, et al. Neuronal autoantibody titers in the course of small cell lung carcinoma and platinum associated neuropathy. Cancer Immunol Immunother 1999;48(2-3):85-90

5. Klein CJ. Autoimmune-mediated peripheral neuropathies and autoimmune pain. In: Pittock SJ, Vincent A, eds. Handbook of Clinical Neurology; Autoimmune Neurology. Elsevier; 2016 pp 417-446

Day(s) Performed

Monday through Thursday

Report Available

5 to 10 days

Performing 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

84182

LOINC Code Information

Test ID Test Order Name Order LOINC Value
CRMWC CRMP-5-IgG Western Blot, CSF 53707-6

 

Result ID Test Result Name Result LOINC Value
21747 CRMP-5-IgG Western Blot, CSF 53707-6