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HelpTest Code T46TC Tripartite Motif-Containing Protein 46 (TRIM46) IgG, Tissue Immunofluorescence Titer, 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
Reporting an end-titer result for tripartite motif-containing protein 46 (TRIM46)-IgG in 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 (CBA) and IFA titer will be performed at an additional charge.
Method Name
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
Indirect Immunofluorescence Assay (IFA)
Reporting Name
TRIM46 Ab IFA Titer, 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
<1:2
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.
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. Shams'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):169-172. 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
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;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 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
86256
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| T46TC | TRIM46 Ab IFA Titer, CSF | 105526-8 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| 616448 | TRIM46 Ab IFA Titer, CSF | 105526-8 |