Test Catalog

Test Id : PCTTC

Not Orderable

Purkinje Cell Cytoplasmic Antibody, Type Tr (PCA-Tr) Titer, Spinal Fluid

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Overview

Test Catalog

Useful For
Suggests clinical disorders or settings where the test may be helpful

Serological testing for Purkinje cell cytoplasmic antibody-Tr for patients with acquired cerebellar ataxia of undetermined etiology, particularly if the patient has a history of Hodgkin lymphoma

 

Reporting an end titer result from spinal fluid specimens

Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.

If the indirect immunofluorescence (IFA) pattern suggests Purkinje cell cytoplasmic antibody, type Tr (PCA-Tr), then this test will be performed at an additional charge

Method Name
A short description of the method used to perform the test

Only orderable as a reflex. For more information see:

DMC2 / Dementia, Autoimmune/Paraneoplastic Evaluation, Spinal Fluid

ENC2 / Encephalopathy, Autoimmune/Paraneoplastic Evaluation, Spinal Fluid

EPC2 / Epilepsy, Autoimmune/Paraneoplastic Evaluation, Spinal Fluid

MDC2 / Movement Disorder, Autoimmune/Paraneoplastic Evaluation, Spinal Fluid

PCDEC / Pediatric Autoimmune Encephalopathy/CNS Disorder Evaluation, Spinal Fluid

 

Indirect Immunofluorescence Assay (IFA)

NY State Available
Indicates the status of NY State approval and if the test is orderable for NY State clients.

Yes

Reporting Name
Lists a shorter or abbreviated version of the Published Name for a test

PCA-Tr Titer, CSF

Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.

If the indirect immunofluorescence (IFA) pattern suggests Purkinje cell cytoplasmic antibody, type Tr (PCA-Tr), then this test will be performed at an additional charge

Specimen Type
Describes the specimen type validated for testing

CSF

Ordering Guidance

Serum is preferred. Spinal fluid testing is particularly useful when interfering antibodies are present in the serum.

Specimen Required
Defines the optimal specimen required to perform the test and the preferred volume to complete testing

Only orderable as a reflex. For more information see:

-DMC2 / Dementia, Autoimmune/Paraneoplastic Evaluation, Spinal Fluid

-ENC2 / Encephalopathy, Autoimmune/Paraneoplastic Evaluation, Spinal Fluid

-EPC2 / Epilepsy, Autoimmune/Paraneoplastic Evaluation, Spinal Fluid

-MDC2 / Movement Disorder, Autoimmune/Paraneoplastic Evaluation, Spinal Fluid

-PCDEC / Pediatric Autoimmune Encephalopathy/CNS Disorder Evaluation, Spinal Fluid

 

Container/Tube: Sterile vial

Specimen Volume: 4 mL

Specimen Minimum Volume
Defines the amount of sample necessary to provide a clinically relevant result as determined by the testing laboratory. The minimum volume is sufficient for one attempt at testing.

2 mL

Reject Due To
Identifies specimen types and conditions that may cause the specimen to be rejected

Gross hemolysis Reject
Gross lipemia Reject
Gross icterus Reject

Specimen Stability Information
Provides a description of the temperatures required to transport a specimen to the performing laboratory, alternate acceptable temperatures are also included

Specimen Type Temperature Time Special Container
CSF Refrigerated (preferred) 28 days
Frozen 28 days
Ambient 72 hours

Useful For
Suggests clinical disorders or settings where the test may be helpful

Serological testing for Purkinje cell cytoplasmic antibody-Tr for patients with acquired cerebellar ataxia of undetermined etiology, particularly if the patient has a history of Hodgkin lymphoma

 

Reporting an end titer result from spinal fluid specimens

Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.

If the indirect immunofluorescence (IFA) pattern suggests Purkinje cell cytoplasmic antibody, type Tr (PCA-Tr), then this test will be performed at an additional charge

Clinical Information
Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test

Purkinje cell autoantibodies are among the antineuronal Purkinje cell autoantibodies are among the antineuronal autoantibodies that are recognized clinically as markers of a patient's immune response to specific cancers (paraneoplastic autoantibodies).

 

The earliest description of a Purkinje cell cytoplasmic antibody (PCA) was reported by Trotter et al in 1976 as a serological accompaniment of paraneoplastic cerebellar ataxia in a patient with Hodgkin lymphoma.(1) IgG of that specificity was recently characterized more fully by Graus et al,(2) who confirmed the association with Hodgkin lymphoma and named the antibody "anti-Tr" in recognition of Dr. John L. Trotter's original report.

 

To be consistent with a generic classification of neuronal nuclear and cytoplasmic autoantibodies,(3) we introduced the name PCA-Tr to distinguish this Purkinje cell cytoplasmic antibody from PCA-1 (a marker of ovarian or breast carcinoma) and PCA-2 (a marker of small-cell lung carcinoma),(4) which also are found in patients presenting with paraneoplastic neurological autoimmunity.

Reference Values
Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.

Only orderable as a reflex. For more information see:

-DMC2 / Dementia, Autoimmune/Paraneoplastic Evaluation, Spinal Fluid

-ENC2 / Encephalopathy, Autoimmune/Paraneoplastic Evaluation, Spinal Fluid

-EPC2 / Epilepsy, Autoimmune/Paraneoplastic Evaluation, Spinal Fluid

-MDC2 / Movement Disorder, Autoimmune/Paraneoplastic Evaluation, Spinal Fluid

-PCDEC / Pediatric Autoimmune Encephalopathy/CNS Disorder Evaluation, Spinal Fluid

 

<1:2

Neuron-restricted patterns of IgG staining that do not fulfill criteria for Purkinje cell cytoplasmic antibody type Tr may be reported as "unclassified antineuronal IgG." Complex patterns that include non-neuronal elements may be reported as "uninterpretable."

Interpretation
Provides information to assist in interpretation of the test results

A positive value (at 1:2 dilution or higher) is consistent with neurological autoimmunity and justifies a search for Hodgkin lymphoma. Purkinje cell cytoplasmic antibody-Tr (PCA-Tr) has not yet been identified in any other context.

 

Seropositive patients usually have Hodgkin lymphoma and present with subacute cerebellar ataxia.(1-3)

Cautions
Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances

Interference from coexisting autoantibodies may preclude interpretation of the immunofluorescence pattern.

 

A negative result does not exclude neurological autoimmunity or Hodgkin lymphoma.

 

The Purkinje cell cytoplasmic antibody-Tr (PCA-Tr) antigen has not been defined immunochemically. It has been reported, but not yet confirmed that autoantibodies against glutamate receptors may occur in this context.(4

 

No Western blot characteristics have been defined for the PCA-Tr antigen.

Clinical Reference
Recommendations for in-depth reading of a clinical nature

1. Trotter JL, Hendin BA, Osterland CK: Cerebellar degeneration with Hodgkin disease. An immunological study. Arch Neurol. 1976 Sept;33(9):660-661

2. Graus F, Gultekin SH, Ferrer I, Reiriz J, Alberch J, Dalmau J: Localization of the neuronal antigen recognized by anti-Tr antibodies from patients with paraneoplastic cerebellar degeneration and Hodgkin's disease in the rat nervous system. Acta Neuropathologica. 1998 July;96(1):1-7

3. Vernino S, Lennon VA: New Purkinje cell antibody (PCA-2): marker of lung cancer-related neurological autoimmunity. Ann Neurol. 2000 Mar;47(3):297-305

4. Graus F, Vincent A, Pozo-Rosich P, et al: Anti-glial nuclear antibody: marker of lung cancer-related paraneoplastic neurological syndromes. J Neuroimmunol. 2005 Aug;165(1-2):166-171

5. Klein CJ: Autoimmune-mediated peripheral neuropathies and autoimmune pain. In: Pittock SJ, Vincent A, eds. Autoimmune Neurology. Elsevier; 2016:417-446. Aminoff MJ, Boller F, Swaab DF, eds. Handbook of Clinical Neurology; vol 133

Method Description
Describes how the test is performed and provides a method-specific reference

The patient's sample is tested by a standardized immunofluorescence assay that uses a composite frozen section of mouse cerebellum, kidney, and gut tissues. After incubation with sample and washing, fluorescein-conjugated goat-antihuman IgG is applied. Neuron-specific autoantibodies are identified by their characteristic fluorescence staining patterns. Samples that are scored positive for any neuronal nuclear or cytoplasmic autoantibody are titrated to an endpoint. Interference by coexisting non-neuron-specific autoantibodies can usually be eliminated by serologic absorption.(Honorat JA, Komorowski L, Josephs KA, et al: IgLON5 antibody: neurological accompaniments and outcomes in 20 patients. Neurol Neuroimmunol Neuroinflamm 2017 Jul 18;4(5):e385. doi: 10.1212/NXI.0000000000000385)

PDF Report
Indicates whether the report includes an additional document with charts, images or other enriched information

No

Day(s) Performed
Outlines the days the test is performed. This field reflects the day that the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time before the test is performed. Some tests are listed as continuously performed, which means that assays are performed multiple times during the day.

Monday through Sunday

Report Available
The interval of time (receipt of sample at Mayo Clinic Laboratories to results available) taking into account standard setup days and weekends. The first day is the time that it typically takes for a result to be available. The last day is the time it might take, accounting for any necessary repeated testing.

6 to 8 days

Specimen Retention Time
Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded

28 days

Performing Laboratory Location
Indicates the location of the laboratory that performs the test

Rochester

Fees :
Several factors determine the fee charged to perform a test. Contact your U.S. or International Regional Manager for information about establishing a fee schedule or to learn more about resources to optimize test selection.

  • Authorized users can sign in to Test Prices for detailed fee information.
  • Clients without access to Test Prices can contact Customer Service 24 hours a day, seven days a week.
  • Prospective clients should contact their account representative. For assistance, contact Customer Service.

Test Classification
Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR) product.

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
Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Clinic Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.

CPT codes are provided by the performing laboratory.

86256

LOINC® Information
Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the order and results codes of this test. LOINC values are provided by the performing laboratory.

Test Id Test Order Name Order LOINC Value
PCTTC PCA-Tr Titer, CSF 94362-1
Result Id Test Result Name Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
43448 PCA-Tr Titer, CSF 94362-1

Test Setup Resources

Setup Files
Test setup information contains test file definition details to support order and result interfacing between Mayo Clinic Laboratories and your Laboratory Information System.

Excel | Pdf

Sample Reports
Normal and Abnormal sample reports are provided as references for report appearance.

Normal Reports | Abnormal Reports

SI Sample Reports
International System (SI) of Unit reports are provided for a limited number of tests. These reports are intended for international account use and are only available through MayoLINK accounts that have been defined to receive them.

SI Normal Reports | SI Abnormal Reports