Sensory-Motor Neuropathy Complete Antibody Panel

Test code

90136

CPT code(s)*

84181, 86255, 82595, 86334, 82784 (x3), 86431, 86235 (x2), 86038, 86021 (x2), 86036, 86364, 83520 (x9)

In-home collection is not available in your area through Quest Mobile.

Clinical significance

Sensory-Motor Neuropathy Complete Antibody Panel - Sensory-motor neuropathies may occur by various mechanisms. These include development of autoantibodies to neuronal structures such as myelin associated glycoprotein (MAG) antibody, Hu antibody, and the ganglioside antibodies. Sensory-motor neuropathies may also occur via antibody cross-reactivity or local immune complex deposition as seen in autoimmune disease with primarily non-neuronal targets including Sjogren's syndrome (SSA/SSB), systemic lupus erythematosus and related conditions (ANA IFA), celiac disease (tTG antibody), vasculitis (ANCA), and immune complex deposition (cryoglobulins,…

Test resources

Clinical focus

Paraneoplastic Neurological Syndromes: Laboratory Support of Diagnosis

Details

Test details

The information below details the components of this test. For overall setup schedule, see Performing lab & setup schedule.

Included components

Test code	Test name	Orderable separately	Setup schedule
%249	ANA SCREEN, IFA	No	Not provided
%70171	ANCA SCREEN	No	Not provided
%37358	CRYOGLOBULIN SCR W/REFLTO CRYOGLOBULIN PANEL	No	Not provided
%39462	GANGLIOSIDE ASIALO GM 1ANTIBODY (IGG), EIA	No	Not provided
%38836	GANGLIOSIDE ASIALO GM 1ANTIBODY (IGM), EIA	No	Not provided
%38916	GANGLIOSIDE GD1A ANTIBODY(IGG), EIA	No	Not provided
%38964	GANGLIOSIDE GD1A ANTIBODY(IGM), EIA	No	Not provided
%39461	GANGLIOSIDE GD1B ANTIBODY(IGG), EIA	No	Not provided
%37439	GANGLIOSIDE GD1B ANTIBODY(IGM), EIA	No	Not provided
%37093	GANGLIOSIDE GM 1 ABS(IGG AND IGM ), EIA	No	Not provided
%34144	GANGLIOSIDE GQ1B AB(IGG), EIA	No	Not provided
%37053	HU AB SCREEN, IFA, SERUM	No	Not provided
%549	IMMUNOFIXATION, SERUM	No	Not provided
%539	IMMUNOGLOBULIN A	No	Not provided
%543	IMMUNOGLOBULIN G	No	Not provided
%545	IMMUNOGLOBULIN M	No	Not provided
%10063	MAG AB (IGM),WESTERN BLOT	No	Not provided
%8796	MYELOPEROXIDASE ANTIBODY	No	Not provided
%34151	PROTEINASE-3 ANTIBODY	No	Not provided
%4418	RHEUMATOID FACTOR	No	Not provided
%7832	SJOGREN'S ANTIBODIES(SS-A,SS-B)	No	Not provided
%8821	TISSUE TRANSGLUTAMINASEAB, IGA	No	Not provided

Includes

ANA Screen,IFA, with Reflex to Titer and Pattern
If ANA Screen, IFA is positive, then ANA Titer and Pattern will be performed at an additional charge (CPT code(s): 86039).

ANCA Screen with Reflex to ANCA Titer
If ANCA Screen is positive, then C-ANCA Titer and/or P-ANCA Titer, and/or atypical P-ANCA Titer will be performed at an additional charge (CPT code(s): 86037 for each titer performed).

Cryoglobulin Screen with Reflex to Cryoglobulin Reflex
If Cryoglobulin Screen is positive, then Cryoglobulin Reflex will be performed at an additional charge (CPT code(s): 86334, 86329).

Ganglioside Asialo-GM-1 Antibodies (IgG, IgM), EIA
Ganglioside GD1a Antibodies (IgG, IgM), EIA
Ganglioside GD1b Antibodies (IgG, IgM), EIA
Ganglioside GM-1 Antibodies (IgG, IgM), EIA
Ganglioside GQ1b Antibody (IgG), EIA

Hu Antibody Screen with Reflex to Titer and Western Blot
If Hu Antibody Screen, IFA is positive, then Hu Antibody, WB will be performed at an additional charge (CPT code(s): 84181).
If Hu Antibody, WB is positive, then Hu Antibody Titer will be performed at an additional charge (CPT code(s): 86256).

Immunofixation (IFE), Serum

Immunoglobulins (IgG, IgA and IgM)
If IgA (Immunoglobulin A) is less than lower reference range, then Tissue Transglutaminase (tTG) Antibody (IgG) will be performed at an additional charge (CPT code(s): 86364).

Myelin Associated Glycoprotein (MAG) Antibody, with Reflex to MAG-SGPG and MAG, EIA
If MAG Antibody (IgM), WB is positive, then MAG-SGPG Antibody (IgM), EIA and MAG Antibody (IgM), EIA, will be performed at an additional charge (CPT code(s): 83520 x2).

Myeloperoxidase Antibody (MPO)
Proteinase-3 Antibody
Rheumatoid Factor
Sjőgren's Antibodies (SS-A, SS-B)

Tissue Transglutaminase (tTG) Antibody (IgA)
If Tissue Transglutaminase (tTG) Antibody (IgA) is positive (≥15.0 U/mL), then Endomysial Antibody Screen (IgA) with Reflex to Titer will be performed at an additional charge (CPT code(s): 86231).
If Endomysial Antibody Screen (IgA) is positive, then Endomysial Antibody Titer will be performed at an additional charge (CPT code(s): 86231).

Methodology

See individual tests

Assay category

This test was developed and its analytical performance characteristics have been determined by Quest Diagnostics. It has not been cleared or approved by FDA. This assay has been validated pursuant to the CLIA regulations and is used for clinical purposes.

Specimen requirements
Patient preparation	Overnight fasting is required
Preferred specimen(s)	23.2 mL serum collected in a red-top tube (no gel)
Minimum volume	10.5 mL
Collection instructions	See individual tests. Multiple tubes required for testing. Cryoglobulin Screen and reflex: 3 mL serum required: 2 mL minimum. Since multiple tubes are needed for this panel, designate one tube exclusively for cryoglobulin and treat it differently from the other tubes collected. Allow blood in the tube designated for cryoglobulin to clot for one (1) hour in a 37° C water bath, incubator, heat block, or heel warmer. After clotting, centrifuge the specimen as quickly as possible. It is not necessary to use a warm centrifuge but do not use a refrigerated one. Decant all of the cryoglobulin serum into one screw-cap vial (do not aliquot any of the cryoglobulin serum into any other tube). Transport at room temperature. NOTE: If the sample is NOT kept at 37° C during clotting, the cryoglobulin, if present, can precipitate during centrifugation and be lost in the clot resulting in a false negative result.
Transport container	Transport tubes
Transport temperature	See individual tests
Specimen stability	See individual tests
Reject criteria	Gross hemolysis • Grossly lipemic • Icteric • Serum separator tube (SST) • Plasma

Reflex tests

Test code	Test name	Orderable separately	Reflex criteria
%36209	ANA, TITER AND PATTERN	No	If ANA Screen, IFA is Positive, then ANA Titer and Pattern will be performed.
%70160	C ANCA TITER	No	If ANCA Screen is Positive, then C-ANCA Titer and/or P-ANCA Titer, and/or Atypical P-ANCA Titer will be performed.
%70161	P ANCA TITER	No	...
%70162	ATYPICAL P ANCA TITER	No	...
%91345	CRYOGLOBULIN REFLEX	No	If Cryoglobulin Screen is Positive, then Cryoglobulin Reflex will be performed.
%37543	HU AB,WESTERN BLOT,SERUM	No	If Hu Antibody Screen, IFA is Positive, then Hu Antibody, WB will be performed.
%37542	HU AB TITER, SERUM	No	If Hu Antibody, WB is Positive, then Hu Antibody Titer will be performed.
%11070	TISSUE TRANSGLUTAMINASE AB, IGG	No	If IgA (Immunoglobulin A) is less than lower reference range, then Tissue Transglutaminase (tTG) Antibody (IgG) will be performed.
%37078	MAG SGPG AB (IGM),EIA	No	If MAG Antibody (IgM), WB is Positive, then MAG-SGPG Antibody (IgM), EIA will be performed.
%37438	MYELIN ASSOC GLYCOPROTEIN (MAG) IGM, EIA	No	If MAG Antibody (IgM), WB is Positive, then MAG Antibody (IgM), EIA, will be performed.
%14506	ENDOMYSIAL ANTIBODY SCREEN (IGA)	No	If Tissue Transglutaminase (tTG) Antibody (IgA) is Positive (≥15.0 U/mL), then Endomysial Antibody Screen (IgA) with Reflex to Titer will be performed.
%15246	ENDOMYSIAL ANTIBODY TITER	No	If Endomysial Antibody Screen (IgA) is Positive, then Endomysial Antibody Titer will be performed.

Reference range(s)

See individual tests

LOINC® codes

The Result and LOINC® information listed below should not be used for electronic interface maintenance with Quest Diagnostics. Please contact the Quest Diagnostics Connectivity Help Desk for more information at 800-697-9302.

NOTE: The codes listed in the table are not orderable Test Codes

Result code	Result name	LOINC code	Component name
40000700	TISSUE TRANSGLUTAMINASE AB, IGA	31017-7	Tissue transglutaminase Ab.IgA
45017500	IFE INTERPRETATION	25700-6	Interpretation
45047100	PROTEINASE-3 ANTIBODY	46267-1	Proteinase 3 Ab
45047200	MYELOPEROXIDASE ANTIBODY	46266-3	Myeloperoxidase Ab
45060420	ANA SCREEN, IFA	42254-3	Nuclear Ab
45061015	SJOGREN'S ANTIBODY (SS-A)	33569-5	Sjogrens syndrome-A extractable nuclear Ab
45061020	SJOGREN'S ANTIBODY (SS-B)	45142-7	Sjogrens syndrome-B extractable nuclear Ab
45073600	IMMUNOGLOBULIN A	2458-8	IgA
45073700	IMMUNOGLOBULIN G	2465-3	IgG
45073800	IMMUNOGLOBULIN M	2472-9	IgM
85991142	HU AB, IFA, SERUM	49738-8	Neuronal nuclear Ab
85991299	GANGLIOSIDE GM 1 ANTIBODY (IGG), EIA	43240-1	Ganglioside GM1 Ab.IgG
85991300	GM 1 AB (IGM)	43241-9	Ganglioside GM1 Ab.IgM
85991839	CRYOGLOBULIN, QL	5117-7	Cryoglobulin
85992165	GANGLIOSIDE GD1B ANTIBODY (IGM), EIA	13661-4	Ganglioside GD1b Ab.IgM
85992622	RHEUMATOID FACTOR	11572-5	Rheumatoid factor
85992967	MAG AB (IGM),WESTERN BLOT	31023-5	Myelin associated glycoprotein Ab.IgM
85993209	GANGLIOSIDE GQ1B AB (IGG), EIA	14254-7	Ganglioside GQ1b Ab.IgG
85995733	GANGLIOSIDE ASIALO GM 1 ANTIBODY (IGM), EIA	10359-8	Asialoganglioside GM1 Ab.IgM
85996005	GANGLIOSIDE GD1A ANTIBODY (IGG), EIA	21283-7	Ganglioside GD1a Ab.IgG
85996006	GANGLIOSIDE GD1A ANTIBODY (IGM), EIA	21282-9	Ganglioside GD1a Ab.IgM
85996324	GANGLIOSIDE GD1B ANTIBODY (IGG), EIA	13662-2	Ganglioside GD1b Ab.IgG
85996325	GANGLIOSIDE ASIALO GM 1 ANTIBODY (IGG), EIA	13663-0	Asialoganglioside GM1 Ab.IgG
86003302	ANCA SCREEN	17351-8	Neutrophil cytoplasmic Ab

ANA, TITER AND PATTERN

Result code	Result name	LOINC code	Component name
45060150	ANA PATTERN	13068-2	Nuclear Ab pattern
45060160	ANA TITER	5048-4	Nuclear Ab
86025609	ANA TITER	5048-4	Nuclear Ab
86025610	ANA PATTERN	13068-2	Nuclear Ab pattern
86025611	ANA TITER	5048-4	Nuclear Ab
86025612	ANA PATTERN	13068-2	Nuclear Ab pattern

C ANCA TITER

Result code	Result name	LOINC code	Component name
85996829	C ANCA TITER	14277-8	Neutrophil cytoplasmic Ab.classic

P ANCA TITER

Result code	Result name	LOINC code	Component name
85996830	P ANCA TITER	14278-6	Neutrophil cytoplasmic Ab.perinuclear

ATYPICAL P ANCA TITER

Result code	Result name	LOINC code	Component name
86003301	ATYPICAL P ANCA TITER	49503-6	Neutrophil cytoplasmic Ab.perinuclear.atypical

CRYOGLOBULIN REFLEX

Result code	Result name	LOINC code	Component name
85991848	% CRYOCRIT	15174-6	Cryoglobulin/Serum.total
85991849	CRYOCRIT IMMUNOFIXATION	15175-3	Cryoproteins
85991850	CRYOCRIT IMMUNODIFFUSION	48614-2	Cryoglobulin

HU AB,WESTERN BLOT,SERUM

Result code	Result name	LOINC code	Component name
85991144	HU AB,WESTERN BLOT,SERUM	35278-1	Neuronal nuclear Ab

HU AB TITER, SERUM

Result code	Result name	LOINC code	Component name
85991143	HU AB TITER, SERUM	15398-1	Neuronal nuclear Ab

TISSUE TRANSGLUTAMINASE AB, IGG

Result code	Result name	LOINC code	Component name
40000900	TISSUE TRANSGLUTAMINASE AB, IGG	32998-7	Tissue transglutaminase Ab.IgG

MAG SGPG AB (IGM),EIA

Result code	Result name	LOINC code	Component name
85991239	MAG SGPG AB (IGM),EIA	43190-8	Myelin associated glycoprotein-sulfated glucuronic paragloboside Ab.IgM

MYELIN ASSOC GLYCOPROTEIN (MAG) IGM, EIA

Result code	Result name	LOINC code	Component name
85992164	MYELIN ASSOC GLYCOPROTEIN (MAG) IGM, EIA	39087-2	Myelin associated glycoprotein Ab.IgM

ENDOMYSIAL ANTIBODY SCREEN (IGA)

Result code	Result name	LOINC code	Component name
45060440	ENDOMYSIAL ANTIBODY SCR (IGA) W/REFL TO TITER	10362-2	Endomysium Ab.IgA

ENDOMYSIAL ANTIBODY TITER

Result code	Result name	LOINC code	Component name
45060445	ENDOMYSIAL ANTIBODY TITER	27038-9	Endomysium Ab.IgA

Performing lab & setup schedule

Performing laboratory

Quest Diagnostics Nichols Institute-San Juan Capistrano, CA

33608 Ortega Highway

San Juan Capistrano, CA 92675-2042

Setup schedule

Information not provided in New England (MA, ME, RI, VT, Northern CT, NH) – Contact lab or Customer service to determine turnaround time

Reference ranges are provided as general guidance only. To interpret test results use the reference range in the laboratory report.

*The CPT codes provided are based on AMA guidance and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.

This material contains content from LOINC® (http://loinc.org). The LOINC Table, LOINC Table Core are copyright © 1995-2019, Regenstrief Institute, Inc. and the Logical Observation Identifiers Names and Codes (LOINC) Committee and is available at no cost under the license at http://loinc.org/license.

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