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HelpTest Code CRMTS Collapsin Response-Mediator Protein-5 (CRMP-5) Neuronal IgG Titer, Serum
Specimen Required
Only orderable as a reflex. For more information see:
-PAVAL / Paraneoplastic, Autoantibody Evaluation, Serum
-DMS2 / Dementia, Autoimmune/Paraneoplastic Evaluation, Serum
-ENS2 / Encephalopathy, Autoimmune/Paraneoplastic Evaluation, Serum
-EPS2 / Epilepsy, Autoimmune/Paraneoplastic Evaluation, Serum
-MDS2 / Movement Disorder, Autoimmune/Paraneoplastic Evaluation, Serum
-MAS1 / Myelopathy, Autoimmune/Paraneoplastic Evaluation, Serum
-DYS2 / Dysautonomia, Autoimmune/Paraneoplastic Evaluation, Serum
-GID2 / Gastrointestinal Dysmotility, Autoimmune/Paraneoplastic Evaluation, Serum
-PVLE / Paraneoplastic Vision Loss Evaluation, Serum
-AIAES / Axonal Neuropathy, Autoimmune/Paraneoplastic Evaluation, Serum
Secondary ID
43436Useful For
Evaluation of neurological autoimmunity particularly that associated with small-cell lung carcinoma and thymoma
Reporting an end titer result from serum specimens
Testing Algorithm
If the indirect immunofluorescence pattern suggests collapsin response-mediator protein-5 (CRMP-5) neuronal IgG, then this test will be performed at an additional charge.
Method Name
Only orderable as a reflex. For more information see:
-PAVAL / Paraneoplastic, Autoantibody Evaluation, Serum
-DMS2 / Dementia, Autoimmune/Paraneoplastic Evaluation, Serum
-ENS2 / Encephalopathy, Autoimmune/Paraneoplastic Evaluation, Serum
-EPS2 / Epilepsy, Autoimmune/Paraneoplastic Evaluation, Serum
-MDS2 / Movement Disorder, Autoimmune/Paraneoplastic Evaluation, Serum
-MAS1 / Myelopathy, Autoimmune/Paraneoplastic Evaluation, Serum
-DYS2 / Dysautonomia, Autoimmune/Paraneoplastic Evaluation, Serum
-GID2 / Gastrointestinal Dysmotility, Autoimmune/Paraneoplastic Evaluation, Serum
-PVLE / Paraneoplastic Vision Loss Evaluation, Serum
-AIAES / Axonal Neuropathy, Autoimmune/Paraneoplastic Evaluation, Serum
Indirect Immunofluorescence Assay (IFA)
Specimen Type
SerumSpecimen Minimum Volume
0.6 mL
Specimen Stability Information
| Specimen Type | Temperature | Time |
|---|---|---|
| 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
Only orderable as a reflex. For more information see:
-PAVAL / Paraneoplastic, Autoantibody Evaluation, Serum
-DMS2 / Dementia, Autoimmune/Paraneoplastic Evaluation, Serum
-ENS2 / Encephalopathy, Autoimmune/Paraneoplastic Evaluation, Serum
-EPS2 / Epilepsy, Autoimmune/Paraneoplastic Evaluation, Serum
-MDS2 / Movement Disorder, Autoimmune/Paraneoplastic Evaluation, Serum
-MAS1 / Myelopathy, Autoimmune/Paraneoplastic Evaluation, Serum
-DYS2 / Dysautonomia, Autoimmune/Paraneoplastic Evaluation, Serum
-GID2 / Gastrointestinal Dysmotility, Autoimmune/Paraneoplastic Evaluation, Serum
-PVLE / Paraneoplastic Vision Loss Evaluation, Serum
-AIAES / Axonal Neuropathy, Autoimmune/Paraneoplastic Evaluation, Serum
<1:240
Note: Titers lower than 1:240 are detectable by recombinant collapsin response-mediator protein-5 (CRMP-5) Western blot analysis. CRMP-5 Western blot analysis will be done on request on stored serum (held 4 weeks). This supplemental testing is recommended in cases of chorea, vision loss, cranial neuropathy, and myelopathy. Call 1-800-533-1710 to request CRMP-5 Western blot.
Neuron-restricted patterns of IgG staining that do not fulfill criteria for CRMP-5-IgG may be reported as "unclassified antineuronal IgG." Complex patterns that include non-neuronal elements may be reported as "uninterpretable."
Interpretation
Detection of IgG autoantibody specific for the neuronal cytoplasmic antigen collapsin response-mediator protein-5 (CRMP-5) in a patient's serum or spinal fluid confirms that the patient's subacute neurological disorder has an autoimmune basis and predicts a small-cell lung carcinoma or thymoma with 75% to 80% certainty.(1)
CRMP-5-IgG titers generally fall after the neoplasm is treated, and a rising titer is indicative of tumor persistence or recurrence.
Method Description
The patient's specimen is tested by a standardized immunofluorescence assay that uses a composite frozen section of mouse cerebellum, kidney, and gut tissues. After incubation with the specimen and washing, fluorescein-conjugated goat-antihuman IgG is applied. Neuron-specific autoantibodies are identified by their characteristic fluorescence staining patterns. Specimens that are scored positive for any neuronal nuclear or cytoplasmic autoantibody are titrated. 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;4[5]:e385. Published 2017 Jul 18. doi:10.1212/NXI.0000000000000385)
Western blot analysis with recombinant CRMP-5 (done by specific request) may be required to confirm positive results if interfering autoantibodies are present or when the titer is below 1:120. Western blot testing will also be done by specific request.
Day(s) Performed
Monday through Sunday
Report Available
5 to 8 daysSpecimen Retention Time
28 daysPerforming Laboratory
Mayo Clinic Laboratories in Rochester
CPT Code Information
86256
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| CRMTS | CRMP-5-IgG Titer, S | 94815-8 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| 43436 | CRMP-5-IgG Titer, S | 94815-8 |