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HelpTest Code Billings Clinic: 0174 Mayo: CDS1 CNS Demyelinating Disease Evaluation, Serum
Reporting Name
CNS Demyelinating Disease Eval, SPerforming Laboratory
Mayo Clinic Laboratories in Rochester
Useful For
Diagnosis of inflammatory demyelinating diseases (IDDs) with similar phenotype to neuromyelitis optica spectrum disorder (NMOSD), including optic neuritis (single or bilateral) and transverse myelitis
Diagnosis of autoimmune myelin oligodendrocyte glycoprotein-opathy
Diagnosis of neuromyelitis optica
Distinguishing NMOSD, acute disseminated encephalomyelitis (ADEM), optic neuritis, and transverse myelitis from multiple sclerosis early in the course of disease
Diagnosis of ADEM
Prediction of a relapsing disease course
Method Name
Flow Cytometry
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 before initiation of immunosuppressant medication.
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
Collection Instructions: Centrifuge and aliquot serum into a plastic vial.
Specimen Type
SerumSpecimen Minimum Volume
2 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| 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
MYELIN OLIGODENDROCYTE GLYCOPROTEIN FLORESCENCE-ACTIVATED CELL SORTING(FACS)
Negative
Reference values apply to all ages.
NEUROMYELITIS OPTICA/AQUAPORIN-4-IgG FACS
Negative
Reference values apply to all ages.
Interpretation
A positive value for aquaporin-4 (AQP4)-IgG is consistent with an autoimmune astrocytopathy/neuromyelitis optica spectrum disorder (NMOSD) and justifies initiation of appropriate immunosuppressive therapy at the earliest possible time. This allows early initiation and maintenance of optimal therapy. Recommend follow-up in 3 to 6 months if NMOSD is suspected.
A positive value for myelin oligodendrocyte glycoprotein (MOG)-IgG is consistent with a neuromyelitis optica-like phenotype and in the setting of acute disseminated encephalomyelitis, optic neuritis and transverse myelitis, indicates an autoimmune oligodendrogliopathy with potential for relapsing course. Identification of MOG-IgG allows distinction from multiple sclerosis (MS) and may justify initiation of appropriate immunosuppressive therapy (not MS disease-modifying agents) at the earliest possible time. This allows early initiation and maintenance of optimal therapy. Recommend follow-up in 6 to 12 months as persistence of MOG-IgG seropositivity predicts a relapsing course.
Detection of both antibodies is rare and unusual.
AQP4-IgG and MOG-IgG are not found in MS or healthy subjects.
Day(s) Performed
Monday, Tuesday, Thursday
Report Available
7 to 10 daysTest 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
86053
86363
86053-Titer (if appropriate)
86363-Titer (if appropriate)
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| CDS1 | CNS Demyelinating Disease Eval, S | 102085-8 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| 38324 | NMO/AQP4 FACS, S | 43638-6 |
| 65563 | MOG FACS, S | 90248-6 |
| 113625 | CNS Demyelinating Disease Interp, S | 69048-7 |
Forms
If not ordering electronically, complete, print, and send a Neurology Specialty Testing Client Test Request (T732) with the specimen.
Profile Information
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| CSI1 | CNS Demyelinating Disease Interp, S | No | Yes |
| NMOFS | NMO/AQP4 FACS, S | Yes | Yes |
| MOGFS | MOG FACS, S | Yes | Yes |
Reflex Tests
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| NMOTS | NMO/AQP4 FACS Titer, S | No | No |
| MOGTS | MOG FACS Titer, S | No | No |
Testing Algorithm
When the results of this assay require further evaluation of myelin oligodendrocyte glycoprotein (MOG-IgG1), the MOG-IgG1 titer will be performed at an additional charge.
When the results of this assay require further evaluation of neuromyelitis optica (NMO)/Aquaporin-4-IgG, the neuromyelitis optica (NMO)/aquaporin-4-IgG titer will be performed at an additional charge.
For more information, see the following algorithms:
-Pediatric Autoimmune Central Nervous System Demyelinating Disease Diagnostic Algorithm
-Central Nervous System Demyelinating Disease Diagnostic Algorithm