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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 |
|---|---|---|
| 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 specimen is tested by a standardized immunofluorescence assay that uses a composite frozen section of mouse cerebellum, kidney, and gut tissues. After incubation with the specimen and washing, fluorescein-conjugated goat-antihuman IgG is applied. Neuron-specific autoantibodies are identified by their characteristic fluorescence staining patterns. Specimens that are scored positive for any neuronal nuclear or cytoplasmic autoantibody are titrated. 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. Published 2017 Jul 18. 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 |