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Test Code NMOFS Neuromyelitis Optica (NMO)/Aquaporin-4-IgG Fluorescence-Activated Cell Sorting (FACS) Assay, Serum

Important Note

 

Effective 1/12/18

EXPLANATION: To decrease the frequency of test cancellations due to insufficient volume the minimum volume for NMOFS: Neuromyelitis Optica (NMO)/Aquaporin-4-IgG Fluorescence-Activated Cell Sorting (FACS) Assay, Serum is increasing. New minimum volume is 2.0 mL.

Useful For

Diagnosis of a neuromyelitis optica spectrum disorder (NMOSD)

 

Diagnosis of autoimmune AQP4 channelopathy

 

Diagnosis of neuromyelitis optica (NMO)

 

Distinguishing NMOSD from multiple sclerosis early in the course of disease

Reflex Tests

Test ID Reporting Name Available Separately Always Performed
NMOTS NMO/AQP4 FACS Titer, S No No

Testing Algorithm

When the results of this assay require further evaluation, NMOTS / Neuromyelitis Optica (NMO)/Aquaporin-4-IgG Fluorescence-Activated Cell Sorting (FACS) Titer Assay, Serum will be performed at an additional charge.

Method Name

Flow Cytometry

Reporting Name

NMO/AQP4 FACS, S

Specimen Type

Serum


Ordering Guidance


 



Specimen Required


Collection Container/Tube:

Preferred: Red top

Acceptable: Serum gel

Submission Container/Tube: Plastic vial

Specimen Volume: 3 mL

Collection Instructions: Centrifuge and aliquot serum into a plastic vial.


Specimen Minimum Volume

2 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Serum Refrigerated (preferred) 28 days
  Frozen  28 days
  Ambient  72 hours

Reference Values

Negative

Interpretation

A positive value is consistent with a neuromyelitis optica spectrum disorder (NMOSD) and justifies initiation of appropriate immunosuppressive therapy at the earliest possible time. This allows early initiation and maintenance of optimal therapy. Recommend follow-up in 3 to 6 months if NMOSD is suspected.

 

This autoantibody is not found in healthy subjects.

Clinical Reference

1. Wingerchuk DM, Lennon VA, Lucchinetti CF, et al: The spectrum of neuromyelitis optica. Lancet Neurol 2007;6:805-815

2. Lennon VA, Wingerchuk DM, Kryzer TJ, et al: A serum autoantibody marker of neuromyelitis optica; distinction from multiple sclerosis. Lancet 2004;364:2106-2112

3. Pittock SJ, Weinshenker BG, Lucchinetti CF, et al: Neuromyelitis optica brain lesions localized at sites of high aquaporin 4 expression. Arch Neurol 2006 Jul;63(7):964-968

4. McKeon A, Lennon VA, Lotze T, et al: CNS aquaporin-4 autoimmunity in children. Neurology 2008 Jul 8;71(2):93-100

5. Apiwattanakul M, Popescu BF, Matiello M, et al: Intractable vomiting as the initial presentation of NMO. Ann Neurol 2010 Nov;68(5):757-761

6. Waters P, McKeon A, Leite MI, et al: Multicentre comparison of aquaporin-4 IgG assays in NMO spectrum disorders. Neurology 2012;78:665-671

7. Fryer JP, Lennon VA, Pittock SJ, et al: AQP4 autoantibody assay performance in clinical laboratory service. Neurol Neuroimmunol Neuroinflammation 2014;1:e11

Day(s) Performed

Monday, Tuesday, Thursday

Report Available

5 to 8 days

Performing Laboratory

Mayo Clinic Laboratories in Rochester

CPT Code Information

86053

86053-titer (if appropriate)

LOINC Code Information

Test ID Test Order Name Order LOINC Value
NMOFS NMO/AQP4 FACS, S 43638-6

 

Result ID Test Result Name Result LOINC Value
38324 NMO/AQP4 FACS, S 43638-6

Forms

If not ordering electronically, complete, print, and send Neurology Specialty Testing Client Test Request (T732) with the specimen.

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.