23152 Paraneoplastic Autoantibody Evaluation, Serum (PAVAL)

​Ref Lab Code: 83380, Acetylcholine Receptor (Muscle AChR) Antibodies, AChR (Acetylcholine Receptor), AGNA, Amphiphysin Antibody, Serum, ANNA (Antineuronal Nuclear Antibody), Anti-CV2,Anti-Enteric Neuronal Antibody, Anti-GAD65 (Anti-Glutamic Acid Decarboxylase), Anti-Glial Nuclear Antibody, Anti-Hu, Anti-Purkinje CellCytoplasmic Antibodies, Anti-Ri, Anti-Skeletal Muscle Antibodies, Anti-Yo, Antineuronal, APCA (Anti-Purkinje Cell Antibodies), Calcium Channel Blockers, Cerebellar Antibodies, Chorea,Cramp-fasciculation, CRMP-5, IgG, Dorsal Root Ganglion Antibody, Glutamate Decarboxylase Antibodies (GAD65), Hu Antibody, Motor End-Plate Antibody, Motor Nerve Terminal Antibodies, Muscle (Skeletal) Antibodies, Muscle Culture Antibodies, Myoid Antibody, N-Type Calcium Channel Antibody, Neuromyotonia, Neuronal Nuclear Antibody, Neuronal Nuclear Antibody Panel, Neuronal Potassium Channel Ab, Neuronal-Anti, Ovarian Cancer-Related Antibodies, P/Q Type Calcium Channel Antibody, Paraneoplastic Antibodies, Paraneoplastic Autoantibody Evaluation, Paraneoplastic Neurological Autoimmunity, PCA-1 (Purkinje Cell Cytoplasmic Antibodies), PCA-2 (Purkinje Cell Cytoplasmic Antibodies), PCA-Tr (Purkinje Cell Cytoplasmic Antibodies), PCAb(Purkinje Cell Cytoplasmic Antibodies), Potassium Channel Antibodies (specify), Purkinje Cell Cytoplasmic Antibodies, Type 1,Purkinje Cell Cytoplasmic Antibodies, Type 2,Purkinje Cell Cytoplasmic Antibodies, Type Tr, Ri, Anti, Stiff-man Syndrome, Striational (Striated Muscle) Antibodies, VGCC (Voltage-Gated Calcium Channel) Antibodies, VGKC, VGPC,Voltage-Gated Potassium Channel Ab, Yo-Anti, Neuronal Ganglionic Acetylcholine Receptor Antibody, Cantoxin Receptor Antibodies, Collapsin Response-Mediator Protein-5 Antibody (CRMP5), Isaacs Disease, Neuromuscular Hyperexcitability, Purkinje Cell Cytoplasmic Antibodies, 

​Profile includes ACh receptor (muscle) binding Ab, AChR ganglionic neuronal Ab, N-type calcium channel Ab, P/Q-type calcium channel Ab, Striational Ab, Amphiphysin, ANNA-1, ANNA-2, ANNA-3, CRMP-5-IgG, PCA-1, PCA-2, PCA-Tr, AGNA-1, Neuronal voltage gated potassium channel.

​Serological evaluation of patients who present with a subacute neurological disorder of undetermined etiology, especially those with known risk factors for cancer

​Include relevant clinical information, name, phone number, mailing address, and e-mail address (if applicable) of ordering physician.

Confirmation of the presence of CRMP5-IgG with Western Blot will be based on IFA patterns that suggest CRMP5-IgG and the presence of AChR Binding and/or Striational antibodies. CRMP5-IgG Western Blot will also be performed with physician request when ordering the Paraneoplastic Evaluation.
Anti-glial/neuronal nuclear autoantibody-type 1 (AGNA-1) is recognized as a marker of a patient's immune response to a cancer (usually a small lung carcinoma, SCLC) that is usually limited in metastatis, but is manifest as an autoimmune neurological disorder.​

​Antibodies directed at onconeural proteins shared by neurons, glia, muscle, and certain cancers are valuable serological markers of a patient's immune response to cancer. They are not found in healthy subjects, and are usually accompanied by subacute neurological symptoms and signs. Several autoantibodies have a syndromic association, but no autoantibody predicts a specific neurological syndrome. Conversely, a positive autoantibody profile has 80% to 90% predictive value for a specific cancer. It is not uncommon for more than 1 paraneoplastic autoantibody to be detected, each predictive of the same cancer.