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HelpTest Code LAB7463 Glutamic Acid Decarboxylase (GAD65) Antibody Assay, Serum
Additional Codes
GD65S
Useful For
Assessing susceptibility to autoimmune (type 1, insulin-dependent) diabetes mellitus and related endocrine disorders (eg, thyroiditis and pernicious anemia)
Distinguishing between patients with type 1 and type 2 diabetes
Confirming a diagnosis of stiff-man syndrome, autoimmune encephalitis, autoimmune ataxia, brain stem encephalitis, autoimmune epilepsy, autoimmune myelopathy
Performing Laboratory
Mayo Clinic Laboratories in Rochester
Specimen Type
SerumOrdering Guidance
This test should not be requested in patients who have recently received radioisotopes, therapeutically or diagnostically, because of potential assay interference. The specific waiting period before specimen collection will depend on the isotope administered, the dose given, and the clearance rate in the individual patient. Specimens will be screened for radioactivity prior to analysis. Radioactive specimens received in the laboratory will be held 1 week and assayed if sufficiently decayed or canceled if radioactivity remains.
Specimen Required
Collection Container/Tube:
Preferred: Red top
Acceptable: Serum gel
Submission Container/Tube: Plastic vial
Specimen Volume: 1.5 mL
Collection Instructions: Centrifuge and aliquot serum into a plastic vial.
Specimen Minimum Volume
1 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Serum | Refrigerated (preferred) | 28 days | |
| Frozen | 28 days | ||
| Ambient | 72 hours |
On-campus collections: Send in plastic vial, Refrigerated.
Off-campus collections: Centrifuge and aliquot within 1 hour. Specimen to be stored/transported at Refrigerated temp.
Reject Due To: Gross hemolysis, Gross lipemia, Gross icterus.
Reference Values
≤0.02 nmol/L
Reference values apply to all ages.
Day(s) Performed
Monday through Sunday
CPT Code Information
86341
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| GD65S | GAD65 Ab Assay, S | 30347-9 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| 81596 | GAD65 Ab Assay, S | 30347-9 |
Interpretation
High titers (≥20.0 nmol/L) are found in classic stiff-person syndrome (93% positive) and in related autoimmune neurologic disorders (eg, acquired cerebellar ataxia, some acquired non-paraneoplastic encephalomyelopathies).
Diabetic patients with polyendocrine disorders generally have glutamic acid decarboxylase antibody values 0.02 nmol/L or above.
Values in patients who have type 1 diabetes without a polyendocrine or autoimmune neurologic syndrome are usually 0.02 nmol/L or below. Low titers (0.03-19.9 nmol/L) are detectable in the serum of approximately 80% of type 1 diabetic patients. Conversely, low titers are detectable in the serum of less than 5% of patients with type 2 diabetes. Testing for autoimmune type 1 diabetes is complimented by testing for insulin, islet cell (IA-2), and ZnT8 antibodies.
Eight percent of healthy Olmsted County residents over age 50 years have low-positive values and may be at risk for future autoimmune disease.
Values 0.03 nmol/L or above are consistent with susceptibility to autoimmune (type 1) diabetes and related endocrine disorders (thyroiditis and pernicious anemia).
Method Description
(125)I-labeled recombinant human glutamic acid decarboxylase 65 (GAD65) is incubated with the patient sample. Anti-human IgG is then added to form an immunoprecipitate. After washing the immunoprecipitate, the amount of (125)I-labeled antigen in the immunoprecipitate is measured using a gamma-counter. The amount of gamma emission in the precipitate is proportional to the amount of GAD65-IgG in the sample. Results are reported as units of precipitated antigen (nMol) per L of patient sample.(Walikonis JE, Lennon VA. Radioimmunoassay for glutamic acid decarboxylase [GAD65] autoantibodies as a diagnostic aid for stiff-man syndrome and a correlate of susceptibility to type 1 diabetes mellitus. Mayo Clin Proc. 1998;73[12]:1161-1166; Horta ES, Lennon VA, Lachance DH, et al. Neural autoantibody clusters aid diagnosis of cancer. Clin Cancer Res. 2014;20[14]:3862-9386)
Report Available
3 to 6 daysSpecimen Retention Time
28 daysReject Due To
| Gross hemolysis | Reject |
| Gross lipemia | Reject |
| Gross icterus | Reject |
Method Name
Radioimmunoassay (RIA)
Forms
-General Request (T239)