Test ID: DMC2    
Dementia, Autoimmune Evaluation, Spinal Fluid

Investigating new onset dementia and cognitive impairment plus 1 or more of the following accompaniments using cerebrospinal fluid specimens:

-Rapid onset and progression

-Fluctuating course

-Psychiatric accompaniments (psychosis, hallucinations)

-Movement disorder (myoclonus, tremor, dyskinesias)

-Headache

-Autoimmune stigmata (personal history or family history or signs of diabetes mellitus,  thyroid disorder, vitiligo, poliosis [premature graying], myasthenia gravis, rheumatoid arthritis, systemic lupus erythematosus)

-Smoking history (20+ pack years) or other cancer risk factors

-History of cancer

-Inflammatory cerebrospinal fluid

-Neuroimaging findings atypical for degenerative etiology

If indirect immunofluorescence assay (IFA) pattern suggests AGNA-1 antibody, then AGNA-1 immunoblot is performed at an additional charge.

If IFA pattern suggests ANNA-1 antibody, then ANNA-1 immunoblot is performed at an additional charge.

If IFA pattern suggests ANNA-2 antibody, then ANNA-2 immunoblot is performed at an additional charge.

If IFA pattern suggest amphiphysin antibody, then amphiphysin immunoblot is performed at an additional charge,

If IFA pattern suggest PCA-1 antibody, then PCA-1 immunoblot is performed at an additional charge,

If IFA pattern suggest PCA-Tr antibody, then PCA-Tr immunoblot is performed at an additional charge,

If client requests or if IFA patterns suggest CRMP-5-IgG, then CRMP-5-IgG Western blot is performed at an additional charge.

If IFA pattern suggests AMPA-receptor antibody, and AMPA-receptor antibody cell-binding assay (CBA) is positive, then AMPA-receptor antibody IFA titer assay is performed at an additional charge.

If IFA pattern suggests GABA-B-receptor antibody, and GABA-B-receptor antibody CBA is positive, then GABA-B-receptor antibody IFA titer assay is performed at an additional charge.

If IFA pattern suggests GFAP antibody, then GFAP IFA titer and GFAP CBA are performed at an additional charge.

If IFA pattern suggests NMDA-receptor antibody, and NMDA-receptor antibody CBA is positive, then NMDA-receptor antibody IFA titer assay is performed at an additional charge.

If IFA pattern suggests DPPX antibody, then DPPX antibody CBA and DPPX antibody IFA titer are performed at an additional charge.

If IFA pattern suggests mGluR1 antibody, then mGluR1 antibody CBA and mGluR1 antibody IFA titer are performed at an additional charge.

If IFA pattern suggests IgLON5 antibody, then IgLON5 antibody CBA and IgLON5 IFA titer are performed at an additional charge.

If IFA pattern suggests NIF antibody, then alpha internexin CBA, NIF heavy chain CBA, NIF light chain CBA, and NIF IFA titer are performed at an additional charge.

See Dementia Autoimmune Evaluation Algorithm-Spinal Fluid in Special Instructions.

• Dementia Autoimmune Evaluation Algorithm-Spinal Fluid

AGN1C, AMPHC, AMPIC, ANN1C, ANN2C, ANN3C, CRMC, DPPIC, DPPTC, GABIC, GFAIC, GFATC, GL1IC, GL1TC, IG5IC, IG5TC, NIFIC, NIFTC, NMDIC, PCA1C, PCA2C, PCTRC: Indirect Immunofluorescence Assay (IFA)

AINCC, AMPCC, CS2CC, DPPCC, GABCC, GFACC, GL1CC, IG5CC, LG1CC, NFHCC, NFLCC, NMDCC: Cell-Binding Assay (CBA)

AGNBC, AMIBC, AN1BC, AN2BC, PC1BC, PCTBC: Immunoblot

CRMWC: Western Blot (WB)

GD65C: Radioimmunoassay (RIA)