Test Code CNES Peripheral Nervous System Comprehensive Neuropathy, Autoimmune Evaluation, Serum
Ordering Guidance
Multiple neurological phenotype-specific autoimmune/paraneoplastic evaluations are available. For more information as well as phenotype-specific testing options, refer to Autoimmune Neurology Test Ordering Guide.
For a list of antibodies performed with each evaluation, see Autoimmune Neurology Antibody Matrix.
Specimen Required
Patient Preparation: For optimal antibody detection, specimen collection is recommended to occur before starting immunosuppressant medication or intravenous immunoglobulin (IVIg) treatment.
Supplies: Sarstedt Aliquot Tube, 5 mL (T914)
Collection Container/Tube:
Preferred: Red top
Acceptable: Serum gel
Submission Container/Tube: Plastic vial
Specimen Volume: 3 mL Serum
Collection Instructions: Centrifuge and aliquot serum into a plastic vial.
Useful For
Evaluating patients with suspected immune mediate peripheral neuropathy
Profile Information
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| CNEI | Comprehensive Neuropathy Interp, S | No | Yes |
| AMPHS | Amphiphysin Ab, S | No | Yes |
| AGN1S | Anti-Glial Nuclear Ab, Type 1 | No | Yes |
| ANN1S | Anti-Neuronal Nuclear Ab, Type 1 | No | Yes |
| ANN3S | Anti-Neuronal Nuclear Ab, Type 3 | No | Yes |
| APBIS | AP3B2 IFA, S | No | Yes |
| CS1CS | CASPR1-IgG CBA, S | No | Yes |
| CS2CS | CASPR2-IgG CBA, S | No | Yes |
| CONCS | Contactin-1 IgG CBA, S | No | Yes |
| CRMS | CRMP-5-IgG, S | No | Yes |
| GQ1ES | GQ1b-IgG ELISA, S | Yes | Yes |
| IGG_D | IgG Disialo. GD1b | No | Yes |
| IGG_M | IgG Monos. GM1 | No | Yes |
| IG5CS | IgLON5 CBA, S | No | Yes |
| IGM_D | IgM Disialo. GD1b | No | Yes |
| IGM_M | IgM Monos. GM1 | No | Yes |
| LG1CS | LGI1-IgG CBA, S | No | Yes |
| MAGES | MAG IgM, S | Yes | Yes |
| NF4FS | Neurofascin-155 IgG4, S | No | Yes |
| PCAB2 | Purkinje Cell Cytoplasmic Ab Type 2 | No | Yes |
Reflex Tests
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| AGNBS | AGNA-1 Immunoblot, S | No | No |
| AGNTS | AGNA-1 Titer, S | No | No |
| APHTS | Amphiphysin Ab Titer, S | No | No |
| AMIBS | Amphiphysin Immunoblot, S | No | No |
| AN1BS | ANNA-1 Immunoblot, S | No | No |
| AN1TS | ANNA-1 Titer, S | No | No |
| AN2BS | ANNA-2 Immunoblot, S | No | No |
| AN3TS | ANNA-3 Titer, S | No | No |
| APBCS | AP3B2 CBA, S | No | No |
| APBTS | AP3B2 IFA Titer, S | No | No |
| CRMTS | CRMP-5-IgG Titer, S | No | No |
| CRMWS | CRMP-5-IgG Western Blot, S | No | No |
| IGDTS | IgG Disialo GD1b Titer, S | No | No |
| IGMTS | IgG Monos GM1 Titer, S | No | No |
| IG5TS | IgLON5 IFA Titer, S | No | No |
| IMDTS | IgM Disialo GD1b Titer, S | No | No |
| IMMTS | IgM Monos GM1 Titer, S | No | No |
| MP1BS | MAP1B Immunoblot, S | No | No |
| PC2TS | PCA-2 Titer, S | No | No |
Testing Algorithm
To assess the probability of your patient having chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) vs mimic disorders, see the Chronic Inflammatory Demyelinating Polyradiculoneuropathy (CIDP) calculator.
If the indirect immunofluorescence assay (IFA) patterns suggest amphiphysin antibody, then the amphiphysin antibody IFA titer and amphiphysin antibody immunoblot will be performed at an additional charge.
If the IFA patterns suggest antiglial nuclear antibody-1 (AGNA-1), then the AGNA-1 antibody IFA titer and AGNA-1 antibody immunoblot will be performed at an additional charge.
If the IFA patterns suggest antineuronal nuclear antibody type 1 (ANNA-1), then the ANNA-1 IFA titer, ANNA-1 immunoblot, and ANNA-2 immunoblot will be performed at an additional charge.
If the client requests or the IFA pattern suggests ANNA-3 antibody, then the ANNA-3 IFA titer will be performed at an additional charge.
If the IFA patterns suggest collapsin response-mediator protein-5 (CRMP-5)-IgG, then the CRMP-5 antibody IFA titer and CRMP-5 antibody Western blot will be performed at an additional charge.
Screening tests are performed for IgG and IgM antibodies to GM1 and GD1b. If positive, the appropriate titer assay will be performed at an additional charge.
If the IFA pattern suggests PCA-2 antibody, then the PCA-2 antibody IFA titer and MAP1B immunoblot will be performed at an additional charge.
For more information see:
-Comprehensive Neuropathy Evaluation Algorithm
Special Instructions
Method Name
CNEI: Technical Interpretation
CS1CS, CS2CS, CONCS, IG5CS, LG1CS, APBCS: Cell Binding Assay (CBA)
GQ1ES, IGG_D, IGG_M, IGM_D, IGM_M, MAGES, IGDTS, IGMTS, IMDTS, IMMTS: Enzyme-Linked Immunosorbent Assay (ELISA)
NF4FS: Flow Cytometry
AMPHS, AGN1S, ANN1S, ANN3S, APBIS, CRMS, PCAB2, AGNTS, APHTS, AN1TS, AN3TS, APBTS, CRMTS, IG5TS, PC2TS: Indirect Immunofluorescence Assay (IFA)
CRMWS: Western Blot (WB)
AGNBS, AMIBS, AN1BS, AN2BS, MP1BS: Immunoblot (IB)
Reporting Name
Comprehensive Neuropathy Ab Eval, SSpecimen Type
SerumSpecimen Minimum Volume
Serum: 2 mL
Specimen Stability Information
| Specimen Type | Temperature | Time |
|---|---|---|
| Serum | Refrigerated (preferred) | 28 days |
| Frozen | 28 days | |
| Ambient | 72 hours |
Reject Due To
| Gross hemolysis | Reject |
| Gross lipemia | Reject |
| Gross icterus | Reject |
Reference Values
|
Test ID |
Reporting Name |
Methodology |
Reference Value |
|
CNEI |
Comprehensive Neuropathy Interp, S |
Interpretation |
N/A |
|
AMPHS |
Amphiphysin Ab, S |
IFA |
Negative |
|
AGN1S |
Anti-Glial Nuclear Ab, Type 1 |
IFA |
Negative |
|
ANN1S |
Anti-Neuronal Nuclear Ab, Type 1 |
IFA |
Negative |
|
ANN3S |
Anti-Neuronal Nuclear Ab, Type 3 |
IFA |
Negative |
|
APBIS |
AP3B2 IFA, S |
IFA |
Negative |
|
CS1CS |
CASPR1-IgG CBA, S |
CBA |
Negative |
|
CS2CS |
CASPR2-IgG CBA, S |
CBA |
Negative |
|
CONCS |
Contactin-1 IgG CBA, S |
CBA |
Negative |
|
CRMS |
CRMP-5-IgG, S |
IFA |
Negative |
|
GQ1ES |
GQ1b ELISA, S |
ELISA |
Negative |
|
IGG_D |
IgG Disialo. GD1b |
ELISA |
Negative |
|
IGG_M |
IgG Monos. GM1 |
ELISA |
Negative |
|
IG5CS |
IgLON5 CBA, S |
CBA |
Negative |
|
IGM_D |
IgM Disialo. GD1b |
ELISA |
Negative |
|
IGM_M |
IgM Monos. GM1 |
ELISA |
Negative |
|
LG1CS |
LGI1-IgG CBA, S |
CBA |
Negative |
|
MAGES |
MAG IgM, S |
ELISA |
<1500 |
|
NF4FS |
Neurofascin-155 IgG4, S |
FC |
Negative |
|
PCAB2 |
Purkinje Cell Cytoplasmic Ab Type 2 |
IFA |
Negative |
Reflex Information:
|
Test ID |
Reporting Name |
Methodology |
Reference Value |
|
AGNBS |
AGNA-1 Immunoblot, S |
IB |
Negative |
|
AGNTS |
AGNA-1 Titer, S |
IFA |
<1:240 |
|
APHTS |
Amphiphysin Ab Titer, S |
IFA |
<1:240 |
|
AMIBS |
Amphiphysin Immunoblot, S |
IB |
Negative |
|
AN1BS |
ANNA-1 Immunoblot, S |
IB |
Negative |
|
AN1TS |
ANNA-1 Titer, S |
IFA |
<1:240 |
|
AN2BS |
ANNA-2 Immunoblot, S |
IB |
Negative |
|
AN3TS |
ANNA-3 Titer, S |
IFA |
<1:240 |
|
APBCS |
AP3B2 CBA, S |
CBA |
Negative |
|
APBTS |
AP3B2 IFA Titer, S |
IFA |
<1:240 |
|
CRMTS |
CRMP-5-IgG Titer, S |
IFA |
<1:240 |
|
CRMWS |
CRMP-5-IgG Western Blot, S |
WB |
Negative |
|
IGDTS |
IgG Disialo GD1b Titer, S |
ELISA |
<1:2000 |
|
IGMTS |
IgG Monos GM1 Titer, S |
ELISA |
<1:2000 |
|
IG5TS |
IgLON5 IFA Titer, S |
IFA |
<1:240 |
|
IMDTS |
IgM Disialo GD1b Titer, S |
ELISA |
<1:2000 |
|
IMMTS |
IgM Monos GM1 Titer, S |
ELISA |
<1:4000 |
|
MP1BS |
MAP1B Immunoblot, S |
IB |
Negative |
|
PC2TS |
PCA-2 Titer, S |
IFA |
<1:240 |
*Methodology abbreviations:
Cell-binding assay (CBA)
Enzyme-linked immunosorbent assay (ELISA)
Flow cytometry (FC)
Immunoblot (IB)
Immunofluorescence assay (IFA)
Western blot (WB)
Day(s) Performed
Monday through Sunday
Report Available
8 to 12 daysPerforming 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
86255x14
83516x5
83520
84182 AGNBS (if appropriate)
86256 AGNTS (if appropriate)
86256 APHTS (if appropriate)
84182 AMIBS (if appropriate)
84182 AN1BS (if appropriate)
86256 AN1TS (if appropriate)
84182 AN2BS (if appropriate)
86256 AN3TS (if appropriate)
86255 APBCS (if appropriate)
86256 APBTS (if appropriate)
86256 CRMTS (if appropriate)
84182 CRMWS (if appropriate)
83520 IGDTS (if appropriate)
83520 IGMTS (if appropriate)
86256 IG5TS (if appropriate)
83520 IMDTS (if appropriate)
83520 IMMTS (if appropriate)
84182 MP1BS (if appropriate)
86256 PC2TS (if appropriate)
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| CNES | Comprehensive Neuropathy Ab Eval, S | In Process |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| 606950 | IgLON5 CBA, S | 96478-3 |
| 621107 | GQ1b-IgG ELISA, S | 63254-7 |
| 621106 | Comprehensive Neuropathy Interp, S | 69048-7 |
| 623393 | CASPR1-IgG CBA, S | 101448-9 |
| 607034 | MAG IgM, S | 39087-2 |
| 614591 | Neurofascin-155 IgG4, S | 100845-7 |
| 616442 | Contactin-1 IgG CBA, S | In Process |
| 615863 | AP3B2 IFA, S | 101907-4 |
| 89080 | AGNA-1, S | 84927-3 |
| 81722 | Amphiphysin Ab, S | 72327-0 |
| 80150 | ANNA-1, S | 33615-6 |
| 83137 | ANNA-3, S | 43102-3 |
| 83077 | CRMP-5-IgG, S | 72504-4 |
| 4416 | IgG Disialo. GD1b | 94868-7 |
| 4412 | IgG Monos. GM1 | 63243-0 |
| 4417 | IgM Disialo. GD1b | 94870-3 |
| 4413 | IgM Monos. GM1 | 63247-1 |
| 83138 | PCA-2, S | 84925-7 |
| 64279 | LGI1-IgG CBA, S | 94287-0 |
| 64281 | CASPR2-IgG CBA, S | 94285-4 |
| 624189 | CASPR1/Contactin-1 Complex | In Process |
| 624190 | IFA Notes | 48767-8 |