Clinical Neurology · Neuro-Immunology
Antibody Panels
Available autoimmune/paraneoplastic antibody panels. Panels use an algorithmic approach — rather than running every assay, certain antibodies are always performed, others are reflexively performed based on initial results, and some antibodies are not included. The table lists each laboratory test (with abbreviation), the antibodies always performed, those performed reflexively, and those not performed.
| Laboratory / Test name / sample (Abbrev) | Always performed | Reflexively performed / Not performed |
|---|---|---|
| Mayo Clinic – Paraneoplastic – Serum (PAVAL) | Tissue IFA: ANNA1,2,3 – PCA1,2 – PCA Tr – AGNA1 – Amphyphysin, CRMP5. RIA: VGCC – AChR binding – AChR ganglionic – VGKC ELISA – Striational Ab. |
Reflexively performed: If AChR +ve → modulating Ab & CRMP-5. If VGKC +ve → CASPR2 & LGI1 CBA. Based on Tissue-IFA pattern, may add → NMO FACS, NMDA CBA, AMPA CBA, GABA-B CBA, GAD Ab assay. If Tissue IFA +ve for specific Ab → confirmed with western blot. Not performed: Ma/Ta; DPPX, Recoverin, GFAP, Zic4. |
| Mayo Clinic – Paraneoplastic – CSF (PAC1) | Only Tissue IFA is performed. | Not performed: Ma/Ta; DPPX – Recoverin – GFAP; Ganglionic AChR – VGCC. |
| Mayo Clinic – Autoimmune encephalopathy – Serum (ENS1) | Tissue IFA: ANNA1,2,3 – PCA1,2 – PCA Tr – AGNA1 – Amphyphysin, CRMP5. RIA: VGCC – AChR binding – AChR ganglionic – VGKC ELISA – GAD65. Cell-based assay: NMDA – AMPA – GABA-B – CASPR2 – LGI1. |
Reflexively performed: If Tissue IFA +ve → western blot confirmation. Not performed: DPPX, Recoverin, GFAP, Zic4. |
| Mayo Clinic – Autoimmune encephalopathy – CSF (ENC1) | Tissue IFA: ANNA1,2,3 – PCA1,2 – PCA Tr – AGNA1 – Amphyphysin, CRMP5. RIA: VGKC – GAD65. Cell-based assay: NMDA – AMPA – GABA-B – CASPR2 – LGI1. |
Reflexively performed: If Tissue IFA +ve → western blot confirmation. Not performed: Ganglionic AChR – VGCC; DPPX – Recoverin – GFAP. |
| Athena – Paraneoplastic Neurological Initial Assessment – Serum (4500) | Ma/Ta, CV2, Amphiphysin, ANNA1,2, PCA1. | Reflexively performed: Brief, limited panel with quick turn-around (3–5 days). Not performed: Narrow spectrum panel. |
| Athena – NeoComplete Paraneoplastic Evaluation – Serum (467) | LGI1, CASPR2, VGKC, NMDA, GAD65, Ma/Ta, CV2, Amphiphysin, ANNA1,2, PCA1, Zic4, Recoverin, VGCC, AChR ganglionic. | Not performed: ANNA3, PCA2, PCATr, AGNA, AChR binding, Striational Ab. |
| Athena – NeoEncephalitis Paraneoplastic Evaluation – Serum (447) | LGI1, CASPR2, VGKC, NMDA, GAD65, Ma/Ta, CV2, Amphiphysin, ANNA1. | Reflexively performed: N.B: only for autoimmune encephalitis of paraneoplastic origin (in cancer patients). Not performed: ANNA2,3, PCA1,2, PCATr, AGNA, VGCC, AChR, AChR ganglionic, NMDA, AMPA. |
| Athena – NeoCerebellar Degeneration paraneolastic eval – Serum (438) | GAD65, Ma/Ta, CV2, Amphiphysin, ANNA1,2, PCA1, Zic4. | Not performed: PCA2, PCATr. |
| Athena – NeoSensory neuropathy paraneoplastic eval – Serum (436) | CV2, Amphiphysin, ANNA1. | |
| Athena – Autoimmune Rapidly Progressive Dementia with Recombx – Serum (1711) | VGKC – CASPR2 – LGI1 – GAD65 – NMDA – Amphiphysin – CV2 – ANNA1 – Ma/Ta. | Not performed: DPPX, PCA, AChR Ganglionic. |
Notes: CBA: cell-based assay – FACS: fluorescence-activated cell sorting – IPA: immunoprecipitation assay. Panels usually require 2ml sample, most paraneoplastic panel turnaround time is 28 days. Athena tests are all serum, not CSF.
Ahmed Koriesh, MD