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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, CSF

Specimen Type

CSF

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

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 days

Specimen Retention Time

28 days

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Test 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

NY State Approved

Yes