Test Code SP5TC Septin-5 Antibody, Tissue Immunofluorescence, Spinal Fluid
Specimen Required
Only orderable as a reflex. For more information see MDC2 / Movement Disorder, Autoimmune/Paraneoplastic Evaluation, Spinal Fluid.
Container/Tube: Sterile vial
Specimen Volume: 1.5 mL
Useful For
Detecting septin-5 IgG in spinal fluid (CSF) specimens
Reporting an end titer result from CSF specimens
Testing Algorithm
If the indirect immunofluorescence pattern suggests septin-5, then septin-5 antibody cell-binding assay and this test will be performed at an additional charge.
Method Name
Only orderable as a reflex. For more information see MDC2 / Movement Disorder, Autoimmune/Paraneoplastic Evaluation, Spinal Fluid.
Indirect Immunofluorescence Assay (IFA)
Reporting Name
Septin-5 IFA Titer, CSFSpecimen Type
CSFSpecimen Minimum Volume
See Specimen Required
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
Septin-5 IgG is a biomarker of a rapidly progressive, but treatable, form of autoimmune cerebellar ataxia. Patients present with subacute onset of cerebellar ataxia with prominent eye movement symptoms (oscillopsia or vertigo). Improvement may occur after immunotherapy.
Reference Values
Only orderable as a reflex. For more information see MDC2 / Movement Disorder, Autoimmune/Paraneoplastic Evaluation, Spinal Fluid.
<1:2
Interpretation
Seropositivity for septin antibodies by indirect immunofluorescence is consistent with a diagnosis of autoimmune disease of the central nervous system. Cell-binding assay testing for septin-5 IgG is required to confirm the diagnosis.
Cautions
Negative results for septin antibodies do not exclude neurological autoimmunity or cancer.
Clinical Reference
1. Honorat JA, Lopez-Chiriboga AS, Kryzer TJ, et al: Autoimmune septin-5 cerebellar ataxia. Neurol Neuroimmunol Neuroinflamm. 2018 Jul 9;5(5):e474
2. Honorat JA, Miske R, Scharf M, et al: 416. Neuronal septin autoimmunity: Differentiated serological profiles and clinical findings. Ann Neurol. 2020 Oct; 88(Suppl 25):S55. Abstract
Method Description
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)
Day(s) Performed
Monday through Sunday
Report Available
5 to 10 daysSpecimen Retention Time
28 daysPerforming Laboratory
Mayo Clinic Laboratories in RochesterTest 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
86256
LOINC Code Information
Test ID | Test Order Name | Order LOINC Value |
---|---|---|
SP5TC | Septin-5 IFA Titer, CSF | 101459-6 |
Result ID | Test Result Name | Result LOINC Value |
---|---|---|
616114 | Septin-5 IFA Titer, CSF | 101459-6 |