Autoimmune Neurologic Disease Panel With Reflex, Serum and CSF

Autoimmune neurologic diseases represent a broad category of conditions characterized by immune dysregulation. Antibodies associated with these conditions may be present in the serum or cerebrospinal fluid (CSF) and can serve as useful markers of disease. Testing for these antineural antibodies should be considered when patients experience subacute onset of new, unexplained neurologic symptoms.

Disease Overview

Autoimmune neurologic diseases may localize to the peripheral nervous system or central nervous system (CNS). They can manifest with diverse symptoms including (but not limited to) brainstem or cerebellar syndromes, dysautonomia, encephalopathy, epilepsy, movement disorders, myelopathy, psychiatric changes, or rapidly progressive dementia. Antineural antibodies serve as useful markers of these diseases, and their detection may help establish a diagnosis, support treatment decisions, aid prognostication, serve as a prerequisite for enrollment in clinical trials, and guide the search for an associated malignancy.

For more information about laboratory testing for autoimmune neurologic diseases, including detailed information about panel test selection, refer to the ARUP Consult Autoimmune Neurologic Diseases - Antineural Antibody Testing topic.

Test Description

ARUP’s serum or CSF Autoimmune Neurologic Disease With Reflex panels can be used for the evaluation of patients with subacute onset of neurologic symptoms with possible autoimmune etiology. Testing for the presence of antineural antibodies in both serum and CSF is recommended in most situations. 

These panels cover a broad range of autoimmune neurologic phenotypes; for greater diagnostic yield and improved turnaround time, consider choosing a phenotype-specific panel (see table below) rather than a broad panel.

Regardless of the panel chosen, order only one panel for serum and/or one panel for CSF; many antineural antibodies are redundant between these panels, and choosing based on the predominant phenotype will provide the most meaningful results. To compare these panels and the antibodies included, refer to ARUP Autoimmune Neurology Panel Components.

Testing for individual autoantibodies is also available separately and can be used for long-term monitoring.

Antibodies Tested and Methodology

Reflex Patterns

Autoimmune Neurologic Disease Panel With Reflex, Serum (3006051) and CSF (3006052) 

Limitations

These tests do not include all known antineural antibodies:

• Some antibodies are extremely rare or are of uncertain clinical significance.
• As testing for newly described antibodies becomes available and their clinical relevance is established, these panels will evolve to reflect these discoveries.

Test Interpretation

Results

Results must be interpreted in the clinical context of the individual patient; test results (positive or negative) should not supersede clinical judgement.