Test Code PCTTC Purkinje Cell Cytoplasmic Antibody, Type Tr (PCA-Tr) Titer, Spinal Fluid
Ordering Guidance
Serum is preferred. Spinal fluid testing is particularly useful when interfering antibodies are present in the serum.
Specimen Required
Only orderable as a reflex. For more information see:
-DMC2 / Dementia, Autoimmune/Paraneoplastic Evaluation, Spinal Fluid
-ENC2 / Encephalopathy, Autoimmune/Paraneoplastic Evaluation, Spinal Fluid
-EPC2 / Epilepsy, Autoimmune/Paraneoplastic Evaluation, Spinal Fluid
-MDC2 / Movement Disorder, Autoimmune/Paraneoplastic Evaluation, Spinal Fluid
-PCDEC / Pediatric Autoimmune Encephalopathy/CNS Disorder Evaluation, Spinal Fluid
Container/Tube: Sterile vial
Specimen Volume: 4 mL
Useful For
Serological testing for Purkinje cell cytoplasmic antibody-Tr for patients with acquired cerebellar ataxia of undetermined etiology, particularly if the patient has a history of Hodgkin lymphoma
Reporting an end titer result from spinal fluid specimens
Testing Algorithm
If the indirect immunofluorescence (IFA) pattern suggests Purkinje cell cytoplasmic antibody, type Tr (PCA-Tr), then this test will be performed at an additional charge
Method Name
Only orderable as a reflex. For more information see:
DMC2 / Dementia, Autoimmune/Paraneoplastic Evaluation, Spinal Fluid
ENC2 / Encephalopathy, Autoimmune/Paraneoplastic Evaluation, Spinal Fluid
EPC2 / Epilepsy, Autoimmune/Paraneoplastic Evaluation, Spinal Fluid
MDC2 / Movement Disorder, Autoimmune/Paraneoplastic Evaluation, Spinal Fluid
PCDEC / Pediatric Autoimmune Encephalopathy/CNS Disorder Evaluation, Spinal Fluid
Indirect Immunofluorescence Assay (IFA)
Reporting Name
PCA-Tr Titer, CSFSpecimen Type
CSFSpecimen Minimum Volume
2 mL
Specimen Stability Information
Specimen Type | Temperature | Time | Special Container |
---|---|---|---|
CSF | Refrigerated (preferred) | 28 days | |
Frozen | 28 days | ||
Ambient | 72 hours |
Reference Values
Only orderable as a reflex. For more information see:
-DMC2 / Dementia, Autoimmune/Paraneoplastic Evaluation, Spinal Fluid
-ENC2 / Encephalopathy, Autoimmune/Paraneoplastic Evaluation, Spinal Fluid
-EPC2 / Epilepsy, Autoimmune/Paraneoplastic Evaluation, Spinal Fluid
-MDC2 / Movement Disorder, Autoimmune/Paraneoplastic Evaluation, Spinal Fluid
-PCDEC / Pediatric Autoimmune Encephalopathy/CNS Disorder Evaluation, Spinal Fluid
<1:2
Neuron-restricted patterns of IgG staining that do not fulfill criteria for Purkinje cell cytoplasmic antibody type Tr may be reported as "unclassified antineuronal IgG." Complex patterns that include non-neuronal elements may be reported as "uninterpretable."
Interpretation
A positive value (at 1:2 dilution or higher) is consistent with neurological autoimmunity and justifies a search for Hodgkin lymphoma. Purkinje cell cytoplasmic antibody-Tr (PCA-Tr) has not yet been identified in any other context.
Seropositive patients usually have Hodgkin lymphoma and present with subacute cerebellar ataxia.(1-3)
Clinical Reference
1. Trotter JL, Hendin BA, Osterland CK: Cerebellar degeneration with Hodgkin disease. An immunological study. Arch Neurol. 1976 Sept;33(9):660-661
2. Graus F, Gultekin SH, Ferrer I, Reiriz J, Alberch J, Dalmau J: Localization of the neuronal antigen recognized by anti-Tr antibodies from patients with paraneoplastic cerebellar degeneration and Hodgkin's disease in the rat nervous system. Acta Neuropathologica. 1998 July;96(1):1-7
3. Vernino S, Lennon VA: New Purkinje cell antibody (PCA-2): marker of lung cancer-related neurological autoimmunity. Ann Neurol. 2000 Mar;47(3):297-305
4. Graus F, Vincent A, Pozo-Rosich P, et al: Anti-glial nuclear antibody: marker of lung cancer-related paraneoplastic neurological syndromes. J Neuroimmunol. 2005 Aug;165(1-2):166-171
5. Klein CJ: Autoimmune-mediated peripheral neuropathies and autoimmune pain. In: Pittock SJ, Vincent A, eds. Autoimmune Neurology. Elsevier; 2016:417-446. Aminoff MJ, Boller F, Swaab DF, eds. Handbook of Clinical Neurology; vol 133
Day(s) Performed
Monday through Sunday
Report Available
6 to 8 daysPerforming Laboratory
Mayo Clinic Laboratories in RochesterTest 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
86256
LOINC Code Information
Test ID | Test Order Name | Order LOINC Value |
---|---|---|
PCTTC | PCA-Tr Titer, CSF | 94362-1 |
Result ID | Test Result Name | Result LOINC Value |
---|---|---|
43448 | PCA-Tr Titer, CSF | 94362-1 |