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HelpTest Code MA2EC Ma2 Antibody, ELISA, Spinal Fluid
Necessary Information
Provide the following information:
1. Relevant clinical information
2. Ordering provider name, phone number, mailing address, and e-mail address
Specimen Required
Container/Tube: Sterile vial
Preferred: Vial number 1
Acceptable: Any vial
Specimen Volume: 2 mL
Useful For
Evaluating patients with suspected paraneoplastic encephalitides using spinal fluid specimens
Method Name
Enzyme-Linked Immunosorbent Assay (ELISA)
Reporting Name
Ma2 Ab ELISA, CSFSpecimen Type
CSFSpecimen Minimum Volume
1 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| CSF | Refrigerated (preferred) | 28 days | |
| Frozen | 28 days | ||
| Ambient | 72 hours |
Reject Due To
| Gross hemolysis | Reject |
| Gross lipemia | Reject |
| Gross icterus | Reject |
Clinical Information
Ma2 antibodies are IgG biomarkers found in patients with paraneoplastic encephalitis (limbic encephalitis or brainstem encephalitis) or cerebellar ataxia. Antibodies (Ab) to Ma antigens can be found directed at Ma2 alone, or both Ma1 and Ma2, but never Ma1 alone. The accompanying neurological disorders (encephalitis, dementia, brainstem encephalitis, cerebellar ataxia) are usually severe. The cancer associations are either testicular germinoma (Ma2 Ab positive only) or diverse (Ma1 and Ma2 Ab positive). Neurological improvement upon treatment of cancer or immunotherapy is more commonly encountered in those seropositive for Ma2 only than when compared to Ma1 and Ma2 together.
Reference Values
Negative
Interpretation
Seropositivity for Ma2 antibody is consistent with a diagnosis of an autoimmune central nervous system disorder (encephalopathy, dementia, seizure disorder, brainstem encephalitis or cerebellar ataxia). A paraneoplastic basis should be considered and include seminoma (testicular or extra-testicular).
Cautions
A negative Ma2 antibody test result does not exclude autoimmune neurological disease or cancer.
Method Description
Ma2 antibodies are directed against their corresponding intracellular protein (PNMA2). The Ma2 autoantibody enzyme-linked immunosorbent assay (ELISA) is based on the principle of indirect ELISA that employs the ability of Ma2 autoantibodies to bind to antigenic protein (PNMA2) coated on the well surface of an ELISA plate. Detection of this bound antibody is accomplished using an antihuman secondary antibody that specifically recognizes the Fc region of the bound autoantibody. The secondary antibody is conjugated with alkaline phosphatase that enzymatically hydrolyzes a substrate molecule to produce an end product with a yellow color measurable at a wavelength of 405 nm. Controls and diluted samples are added in duplicate to coated plate wells and incubated for 2 hours, then washed extensively before adding the conjugated secondary antibody for an additional hour. After aspiration and washing, p-nitrophenyl phosphate substrate is added to each well and incubated for an additional hour before absorbance is measured at 405 nm.(Instruction manual: Capture ELISA Protocols. Abnova; R 1.1, 02/2011)
Day(s) Performed
Tuesday, Friday
Report Available
3 to 5 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
83516
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| MA2EC | Ma2 Ab ELISA, CSF | 101867-0 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| 605971 | Ma2 Ab ELISA, CSF | 101867-0 |