Encephalitis Antibody Evaluation with Reflex, CSF

Encephalitis panel, Autoimmune panel, Encephalopathy-Autoimmune Eval, CSF, Autoimmune Encephalitis Panel, Neurology, Neuroimmunology

Test Codes

Order Reference Lab Miscellaneous Send Out: EPIC: LAB848, Beaker: Ref Lab Misc., Quest: 94958

Department

Send Outs

Specimen Collection Criteria

Collect: 4.0 mL cerebrospinal fluid in a sterile collection container. (Minimum: 2.0 mL)

Physician Office/Draw Specimen Preparation

Maintain specimens refrigerated (2-8°C or 36-46°F) prior to transport.

Preparation for Courier Transport

Transport: 4.0 mL cerebrospinal fluid, refrigerated (2-8°C or 36-46°F). (Minimum: 2.0 mL)

Rejection Criteria

• Received room temperature.
• Specimens not collected and processed as indicated.

In-Lab Processing

Maintain specimens refrigerated (2-8°C or 36-46°F) prior to transport.

Transport: 4.0 mL cerebrospinal fluid, refrigerated (2-8°C or 36-46°F). (Minimum: 2.0 mL)

Storage

Specimen Stability for Testing:

Room Temperature (20-26°C or 68-78.8°F): Unacceptable
Refrigerated (2-8°C or 36-46°F): 7 days
Frozen (-20°C/-4°F or below): 21 days

Specimen Storage in Department Prior to Disposal:

Specimen retention time is determined by the policy of the reference laboratory. Contact the Send Outs Laboratory with any questions.

Laboratory

Sent to Quest Diagnostics, Wood Dale, IL.

Performed

Varies
Results available in 3-12 days.

Reference Range

By report.

Test Methodology

Indirect Immunofluorescence Assay, Western Blot, Immunoblot, Radioimmunoassay, Cell-Binding Assay

Interpretation

If Encephalitis Antibody Screen, Tissue IFA suggests a fluorescence pattern consistent with one or more antibodies including AGNA1 (SOX1), Amphiphysin, ANNA1 (Hu), ANNA2 (Ri), CRMP5(CV2), GAD65, Ma2/Ta, PCA1 (Yo), PCA Tr (DNER), and Zic4, then a line blot consisting of these 10 antibodies will be performed.

If Encephalitis Antibody Screen, Tissue IFA suggests a fluorescence pattern consistent with ANNA3, then titer will be performed.

If Encephalitis Antibody Screen, Tissue IFA suggests a fluorescence pattern consistent with PCA2, then titer will be performed.

If Encephalitis Antibody Screen, Tissue IFA suggests a fluorescence pattern consistent with PCA Tr (DNER) and Neurology Antibody Line Blot shows PCA Tr (DNER) Negative and PCA1 (Yo) Negative, then PCA Tr (DNER) Ab, CBA, CSF will be performed at an additional charge (CPT code(s): 86255).
⁠⁠⁠⁠⁠⁠⁠If PCA Tr (DNER) Ab, CBA, CSF is Positive, then titer will be performed.

If Encephalitis Antibody Screen, Tissue IFA for Myelin suggests a fluorescence pattern consistent with Myelin Antibody, then titer will be performed at an additional charge (CPT code(s): 86256).

If Neurology Antibody, CBA is Positive for NMDAR1, AMPAR2, LGI1, or CASPR2, then titers will be performed at an additional charge (CPT code(s): 86256 for each titer performed).

If Aquaporin 4 (AQP4) Ab, CBA is Positive, then titer will be performed at an additional charge (CPT code (s): 86052).

If Neurology Antibody, CBA is Positive for AMPAR1 or GABABR, then titers will be performed.

If DPPX Antibody, CBA is Positive, then titer will be performed.

Clinical Utility

Encephalitis Antibody Evaluation with Reflex to Titer and Line Blot, CSF – Encephalitis due to anti-neuronal autoantibodies may present in a variety of ways and may be associated with a variety of tumors. Screening for anti-neuronal autoantibodies is performed using tissue immunofluorescence with confirmation by line blot assay. This CSF panel also includes additional testing for autoantibodies frequently associated with encephalitis such as NMDA receptor using cell-based assays. Testing using both serum and CSF increases sensitivity for detection.

CPT Codes

86255 x 19, 86052, 86341, 83519

Contacts

Last Updated

6/10/2026