Autoimmune Dysautonomia Profile

CPT: 83519; 86052; 86255(x7)
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Special Instructions

If reflex test is performed, additional charges/CPT code(s) may apply.


Expected Turnaround Time

5 - 7 days


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Specimen Requirements


Specimen

Serum


Volume

2 mL


Minimum Volume

1 mL (Note: This volume does not allow for repeat testing.)


Container

Gel-barrier tube or red-top tube


Collection

If a tube other than a gel-barrier tube is used, transfer the separated serum to a plastic transport tube. Do not freeze the gel-barrier tube (pour off serum first).


Storage Instructions

Room temperature


Stability Requirements

Temperature

Period

Room temperature

14 days

Refrigerated

14 days

Frozen

14 days

Freeze/thaw cycles

Stable x3


Test Details


Use

This test can be utilized for evaluating symptoms indicative of idiopathic dysautonomia or discerning between autoimmune dysautonomia and the consequences of chemotherapy in individuals undergoing cancer treatment and exhibiting autonomic symptoms.

Autoimmune dysautonomia encompasses disorders affecting the autonomic nervous system's components, triggered by neural-specific IgG or effector T cells. It presents as idiopathic or paraneoplastic, with variable onset and severity. Pandysautonomia manifests gradually with symptoms like impaired pupillary light reflex, anhidrosis, orthostatic hypotension, cardiac arrhythmias, gastrointestinal dysmotility, sicca manifestations and bladder dysfunction. Limited dysautonomia confines symptoms to specific areas, often milder, including sicca manifestations, postural orthostatism, cardiac arrhythmias, bladder dysfunction or gastrointestinal dysmotilities. Diagnosis relies on identifying objective abnormalities via autonomic reflex testing, thermoregulatory sweat test or gastrointestinal motility studies. The most common autoantibody, the neuronal ganglionic alpha-3-acetylcholine receptor (AChR) autoantibody, directly affects dysautonomia severity. Patients with this autoantibody often have cancer, including small-cell lung carcinomas, thymoma, lymphoma and adenocarcinomas. Cancer risks stem from personal or family history, smoking or carcinogen exposure. Early cancer detection improves neurological outcomes. Autoantibodies to other proteins, like antineuronal nuclear antibody-type 1 (ANNA-1) and collapsin response-mediator protein-5 neuronal (CRMP-5-IgG), also mark dysautonomia, predicting specific neoplasms.


Limitations

This test was developed and its performance characteristics determined by Labcorp. It has not been cleared or approved by the Food and Drug Administration.


Methodology

Immunofluorescence (IFA), radioimmunoprecipitation; line blot


LOINC® Map

Order Code Order Code Name Order Loinc Result Code Result Code Name UofM Result LOINC
505413 Autoimmune Dysautonomia 99000-2 505548 Interpretation 56850-1
505413 Autoimmune Dysautonomia 99000-2 085971 Ganglionic AChRab, Serum nmol/L 42233-7
505413 Autoimmune Dysautonomia 99000-2 505241 Anti-Hu Ab 49738-8
505413 Autoimmune Dysautonomia 99000-2 505243 Anti-Ri Ab 43187-4
505413 Autoimmune Dysautonomia 99000-2 505471 Purkinje Cell Cyto Ab Type 2 84925-7
505413 Autoimmune Dysautonomia 99000-2 505486 CRMP-5 IgG 43103-1
505413 Autoimmune Dysautonomia 99000-2 505491 DPPX Antibody 82976-2
505413 Autoimmune Dysautonomia 99000-2 505431 CASPR2 Antibody,Cell-based IFA 82979-6
505413 Autoimmune Dysautonomia 99000-2 505356 LGI1 Antibody, Cell-based IFA 82978-8
505413 Autoimmune Dysautonomia 99000-2 505296 AQP4 Antibody, Cell-based IFA 63439-4
Reflex Table for Anti-Hu Ab
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 505242 Anti-Hu Ab Line Blot 505242 Anti-Hu Ab Line Blot 94389-4
Reflex Table for Anti-Ri Ab
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 505244 Anti-Ri Ab Line Blot 505244 Anti-Ri Ab Line Blot 94387-8
Reflex Table for CRMP-5 IgG
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 505487 CRMP-5 IgG Line Blot 505487 CRMP-5 IgG Line Blot 47401-5
Reflex Table for DPPX Antibody
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 505281 DPPX Cell-based IFA 505281 DPPX Cell-based IFA 94676-4
Reflex 2 505282 DPPX Antibody, Titer, Serum 505282 DPPX Antibody, Titer, Serum 94675-6
Reflex Table for CASPR2 Antibody,Cell-based IFA
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 505432 Anti-CASPR2 Antibody Titer 505432 Anti-CASPR2 Antibody Titer 95600-3
Reflex Table for LGI1 Antibody, Cell-based IFA
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 505357 Anti-LGI1 Antibody Titer,Serum 505357 Anti-LGI1 Antibody Titer,Serum 90831-9
Reflex Table for AQP4 Antibody, Cell-based IFA
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 505298 Anti-AQP4 Antibody, Titer 505298 Anti-AQP4 Antibody, Titer Pending

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The LOINC® codes are copyright © 1994-2021, Regenstrief Institute, Inc. and the Logical Observation Identifiers Names and Codes (LOINC) Committee. Permission is granted in perpetuity, without payment of license fees or royalties, to use, copy, or distribute the LOINC® codes for any commercial or non-commercial purpose, subject to the terms under the license agreement found at https://loinc.org/license/. Additional information regarding LOINC® codes can be found at LOINC.org, including the LOINC Manual, which can be downloaded at LOINC.org/downloads/files/LOINCManual.pdf