Test Code T46CC Tripartite Motif-Containing Protein 46 (TRIM46) IgG, Cell Binding Assay, Spinal Fluid
Specimen Required
Only orderable as a reflex. For more information see:
ENC2 / Encephalopathy, Autoimmune/Paraneoplastic Evaluation, Spinal Fluid
DMC2 / Dementia, Autoimmune/Paraneoplastic Evaluation, Spinal Fluid
EPC2 / Epilepsy, Autoimmune/Paraneoplastic Evaluation, Spinal Fluid
MDC2 / Movement Disorder, Autoimmune/Paraneoplastic Evaluation, Spinal Fluid
MAC1 / Myelopathy, Autoimmune/Paraneoplastic Evaluation, Spinal Fluid
Useful For
Detecting tripartite motif-containing protein 46 (TRIM46)-IgG by cell-binding assay using cerebrospinal fluid specimens
Evaluation of an autoimmune/paraneoplastic neurological syndrome among patients presenting with cerebellar ataxia, encephalitis, or encephalomyelitis
Testing Algorithm
If the indirect immunofluorescence (IFA) pattern suggests tripartite motif-containing protein 46 (TRIM46) IgG, then TRIM46 antibody cell-binding assay and IFA titer will be performed at an additional charge.
Method Name
Only orderable as reflex. For more information see:
ENC2 / Encephalopathy, Autoimmune/Paraneoplastic Evaluation, Spinal Fluid
DMC2 / Dementia, Autoimmune/Paraneoplastic Evaluation, Spinal Fluid
EPC2 / Epilepsy, Autoimmune/Paraneoplastic Evaluation, Spinal Fluid
MDC2 / Movement Disorder, Autoimmune/Paraneoplastic Evaluation, Spinal Fluid
MAC1 / Myelopathy, Autoimmune/Paraneoplastic Evaluation, Spinal Fluid
Cell Binding Assay (CBA)
Reporting Name
TRIM46 Ab CBA, CSFSpecimen Type
CSFSpecimen 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
Tripartite motif-containing protein 46 (TRIM46)-IgG is a marker of an autoimmune neurological disorder commonly associated with underlying malignancy. Patients commonly present with cerebellar ataxia and neoplasms frequently of neuroendocrine lineage.
Reference Values
Only orderable as a reflex. For more information see:
ENC2 / Encephalopathy, Autoimmune/Paraneoplastic Evaluation, Spinal Fluid
DMC2 / Dementia, Autoimmune/Paraneoplastic Evaluation, Spinal Fluid
EPC2 / Epilepsy, Autoimmune/Paraneoplastic Evaluation, Spinal Fluid
MDC2 / Movement Disorder, Autoimmune/Paraneoplastic Evaluation, Spinal Fluid
MAC1 / Myelopathy, Autoimmune/Paraneoplastic Evaluation, Spinal Fluid
Negative
Interpretation
A positive result is consistent with a tripartite motif-containing protein 46 (TRIM46)-IgG associated autoimmune disease of the central nervous system. A paraneoplastic cause should be considered.
Cautions
A negative result does not exclude the presence of neurological autoimmunity or cancer. The use of immunotherapy prior to sample collection may negatively impact the sensitivity of this assay.
Clinical Reference
1. van Coevorden-Hameete MH, van Beuningen SFB, Perrenoud M, et al. Antibodies to TRIM46 are associated with paraneoplastic neurological syndromes. Ann Clin Tran Neurol. 2017;4(9):680-686. doi:10.1002/acn3.396
2. Sham’ili S, de Leeuw B, Hulsenboom E, Jaarsma D, Smitt PS. A new paraneoplastic encephalomyelitis autoantibody reactive with the axon initial segment. Neurosci Lett. 2009;467(2):169-72. doi:10.1016/j.neulet.2009.10.031
3. Valencia-Sanchez C, Knight AM, Hammami B, et al. TRIM46 autoantibody: expanded neurological phenotype and oncological associations (1657). Neurology. 2021;96(15 Supplement). doi:10.1212/WNL.96.15_supplement.1657
Method Description
Patient specimen is applied to a composite slide containing transfected and nontransfected HEK-293 cells. After incubation and washing, fluorescein-conjugated goat-antihuman IgG is applied to detect the presence of patient IgG binding.(Package insert: IIFT: Neurology Mosaics, Instructions for the indirect immunofluorescence test. EUROIMMUN, Lubeck, Germany, FA_112d-1_A_UK_C13, 02/2019)
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
86255
LOINC Code Information
Test ID | Test Order Name | Order LOINC Value |
---|---|---|
T46CC | TRIM46 Ab CBA, CSF | 105524-3 |
Result ID | Test Result Name | Result LOINC Value |
---|---|---|
616450 | TRIM46 Ab CBA, CSF | 105524-3 |