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Test Code CRMTS Collapsin Response-Mediator Protein-5 (CRMP-5) Neuronal IgG Titer, Serum


Specimen Required


Only orderable as a reflex. For more information see:

-PAVAL / Paraneoplastic, Autoantibody Evaluation, Serum

-DMS2 / Dementia, Autoimmune/Paraneoplastic Evaluation, Serum

-ENS2 / Encephalopathy, Autoimmune/Paraneoplastic Evaluation, Serum

-EPS2 / Epilepsy, Autoimmune/Paraneoplastic Evaluation, Serum

-MDS2 / Movement Disorder, Autoimmune/Paraneoplastic Evaluation, Serum

-MAS1 / Myelopathy, Autoimmune/Paraneoplastic Evaluation, Serum

-DYS2 / Dysautonomia, Autoimmune/Paraneoplastic Evaluation, Serum

-GID2 / Gastrointestinal Dysmotility, Autoimmune/Paraneoplastic Evaluation, Serum

-PVLE / Paraneoplastic Vision Loss Evaluation, Serum

-AIAES / Axonal Neuropathy, Autoimmune/Paraneoplastic Evaluation, Serum


Useful For

Evaluation of neurological autoimmunity particularly that associated with small-cell lung carcinoma and thymoma

 

Reporting an end titer result from serum specimens

Method Name

Only orderable as a reflex. For more information see:

-PAVAL / Paraneoplastic, Autoantibody Evaluation, Serum

-DMS2 / Dementia, Autoimmune/Paraneoplastic Evaluation, Serum

-ENS2 / Encephalopathy, Autoimmune/Paraneoplastic Evaluation, Serum

-EPS2 / Epilepsy, Autoimmune/Paraneoplastic Evaluation, Serum

-MDS2 / Movement Disorder, Autoimmune/Paraneoplastic Evaluation, Serum

-MAS1 / Myelopathy, Autoimmune/Paraneoplastic Evaluation, Serum

-DYS2 / Dysautonomia, Autoimmune/Paraneoplastic Evaluation, Serum

-GID2 / Gastrointestinal Dysmotility, Autoimmune/Paraneoplastic Evaluation, Serum

-PVLE / Paraneoplastic Vision Loss Evaluation, Serum

-AIAES / Axonal Neuropathy, Autoimmune/Paraneoplastic Evaluation, Serum

 

Indirect Immunofluorescence Assay (IFA)

Reporting Name

CRMP-5-IgG Titer, S

Specimen Type

Serum

Specimen Minimum Volume

0.6 mL

Specimen Stability Information

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

Reject Due To

Gross hemolysis Reject
Gross lipemia Reject
Gross icterus Reject

Clinical Information

Autoantibodies specific for neurons, glia, and muscle are important serological markers of neurological autoimmunity. Most are highly predictive of specific neoplasms that are metastatic to regional lymph nodes when diagnosed, but usually limited in spread.(1,2) The target autoantigens identified so far include cytoplasmic and nuclear proteins and plasma membrane cation channels.(3)

 

Collapsin response-mediator protein-5 (CRMP-5)-IgG is currently the second most common autoantibody predictive of small-cell lung carcinoma and, sometimes, occurs with thymoma.

 

The neurological presentation of CRMP-5-IgG seropositive patients is usually multifocal and can affect any level of the neuraxis. The presentation frequently mimics a stroke or multiple sclerosis. Syndromic manifestations encountered with lung carcinoma include subacute chorea, blindness, other cranial neuropathies (particularly loss of taste or smell), gastrointestinal dysmotility, myelopathy, and radiculoplexopathy. Fourteen percent of patients have thromboembolic phenomena. Seropositive patients who have thymoma (6%) usually present with neurological manifestations other than, or including, myasthenia gravis (eg, encephalopathy, disorders of continuous muscle fiber activity).

Reference Values

Only orderable as a reflex. For more information see:

-PAVAL / Paraneoplastic, Autoantibody Evaluation, Serum

-DMS2 / Dementia, Autoimmune/Paraneoplastic Evaluation, Serum

-ENS2 / Encephalopathy, Autoimmune/Paraneoplastic Evaluation, Serum

-EPS2 / Epilepsy, Autoimmune/Paraneoplastic Evaluation, Serum

-MDS2 / Movement Disorder, Autoimmune/Paraneoplastic Evaluation, Serum

-MAS1 / Myelopathy, Autoimmune/Paraneoplastic Evaluation, Serum

-DYS2 / Dysautonomia, Autoimmune/Paraneoplastic Evaluation, Serum

-GID2 / Gastrointestinal Dysmotility, Autoimmune/Paraneoplastic Evaluation, Serum

-PVLE / Paraneoplastic Vision Loss Evaluation, Serum

-AIAES / Axonal Neuropathy, Autoimmune/Paraneoplastic Evaluation, Serum

 

<1:240

Note: Titers lower than 1:240 are detectable by recombinant collapsin response-mediator protein-5 (CRMP-5) Western blot analysis. CRMP-5 Western blot analysis will be done on request on stored serum (held 4 weeks). This supplemental testing is recommended in cases of chorea, vision loss, cranial neuropathy, and myelopathy. Call 1-800-533-1710 to request CRMP-5 Western blot.

 

Neuron-restricted patterns of IgG staining that do not fulfill criteria for CRMP-5-IgG may be reported as "unclassified antineuronal IgG." Complex patterns that include non-neuronal elements may be reported as "uninterpretable."

Day(s) Performed

Monday through Sunday

Report Available

5 to 8 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

86256