Test Code AK5IS Adenylate Kinase 5 (AK5) IgG, Tissue Immunofluorescence, Serum (Non-Orderable)
Specimen Required
Only orderable as part of a profile. For more information see:
-DMS2 / Dementia, Autoimmune/Paraneoplastic Evaluation, Serum
-ENS2 / Encephalopathy, Autoimmune/Paraneoplastic Evaluation, Serum
-EPS2 / Epilepsy, Autoimmune/Paraneoplastic Evaluation, Serum
Secondary ID
623399Useful For
Only orderable as part of a profile. For more information see:
DMS2 / Dementia, Autoimmune/Paraneoplastic Evaluation, Serum
ENS2 / Encephalopathy, Autoimmune/Paraneoplastic Evaluation, Serum
EPS2 / Epilepsy, Autoimmune/Paraneoplastic Evaluation, Serum
Evaluation of patients suspected to have autoimmune encephalitis using serum specimens
Reporting adenylate kinase 5 tissue immunofluorescence results as part of a profile
Reflex Tests
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| AK5CS | AK5 Ab CBA, S | No | No |
| AK5TS | AK5 Ab IFA Titer, S | No | No |
Testing Algorithm
If the indirect immunofluorescence (IFA) pattern suggests AK5 (adenylate kinase 5), then the AK5 antibody cell-binding assay and AK5 antibody IFA titer are performed at an additional charge.
Method Name
Only orderable as part of a profile. For more information see:
-DMS2 / Dementia, Autoimmune/Paraneoplastic Evaluation, Serum
-ENS2 / Encephalopathy, Autoimmune/Paraneoplastic Evaluation, Serum
-EPS2 / Epilepsy, Autoimmune/Paraneoplastic Evaluation, Serum
Indirect Immunofluorescence Assay (IFA)
Reporting Name
AK5 Ab IFA, SSpecimen Type
SerumSpecimen Minimum Volume
Serum: 1 mL
Specimen Stability Information
| Specimen Type | Temperature | Time |
|---|---|---|
| Serum | Refrigerated (preferred) | 28 days |
| Frozen | 28 days | |
| Ambient | 72 hours |
Reject Due To
| Gross hemolysis | Reject |
| Gross lipemia | Reject |
| Gross icterus | Reject |
Clinical Information
Adenylate kinase 5 IgG (AK5-IgG) is a marker intended for evaluating patients with autoimmune encephalitis, most often presenting as a non-paraneoplastic limbic encephalitis. Poor response to immunotherapy has been reported while there is no clear cancer association (non-paraneoplastic). AK5-IgG positive patients present with predominant severe amnestic syndrome, associated depression, and anxiety. Epilepsy is often absent at disease onset, however seizures may develop later.
Reference Values
Only orderable as part of a profile. For more information see:
-DMS2 / Dementia, Autoimmune/Paraneoplastic Evaluation, Serum
-ENS2 / Encephalopathy, Autoimmune/Paraneoplastic Evaluation, Serum
-EPS2 / Epilepsy, Autoimmune/Paraneoplastic Evaluation, Serum
Negative
Interpretation
A positive result is consistent with adenylate kinase 5 autoimmunity that manifests with non-paraneoplastic limbic encephalitis.
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)
Day(s) Performed
Varies
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 |
|---|---|---|
| AK5IS | AK5 Ab IFA, S | In Process |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| 623399 | AK5 Ab IFA, S | In Process |