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Test Code PC1TS Purkinje Cell Cytoplasmic Antibody Type 1 (PCA-1) Titer, Serum


Specimen Required


Only orderable as a reflex. For further information see:

PAVAL / Paraneoplastic, Autoantibody Evaluation, Serum

ENS2 / Encephalopathy, Autoimmune/Paraneoplastic Evaluation, Serum

MDS2 / Movement Disorder, Autoimmune/Paraneoplastic Evaluation, Serum

MAS1 / Myelopathy, Autoimmune/Paraneoplastic Evaluation, Serum

AIAES / Axonal Neuropathy, Autoimmune/Paraneoplastic Evaluation, Serum


Secondary ID

43437

Useful For

Identifying female patients whose subacute cerebellar degeneration or peripheral neuropathy is due to a remote (autoimmune) effect of gynecologic or breast carcinoma

 

Reporting an end titer result from serum specimens

Testing Algorithm

If the indirect immunofluorescence pattern suggests Purkinje cell cytoplasmic antibody type 1 (PCA-1), then this test will be performed at an additional charge.

Method Name

Only orderable as a reflex. For further information see:

PAVAL / Paraneoplastic, Autoantibody Evaluation, Serum

ENS2 / Encephalopathy, Autoimmune/Paraneoplastic Evaluation, Serum

MDS2 / Movement Disorder, Autoimmune/Paraneoplastic Evaluation, Serum

MAS1 / Myelopathy, Autoimmune/Paraneoplastic Evaluation, Serum

AIAES / Axonal Neuropathy, Autoimmune/Paraneoplastic Evaluation, Serum

 

Indirect Immunofluorescence Assay (IFA)

Reporting Name

PCA-1 Titer, S

Specimen Type

Serum

Specimen Minimum Volume

0.6 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
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

Purkinje cell antibody type 1 (PCA-1), also known as anti-Yo, binds to Purkinje cell cytoplasm in a characteristic pattern by indirect immunofluorescence. It is found in the serum, and usually cerebrospinal fluid, of patients with paraneoplastic cerebellar degeneration associated with gynecological or breast carcinoma. It is also found in some patients with sensory, sensorimotor neuropathy, or motor neuropathy with gynecologic cancer. Almost all (99%) seropositive patients are women.

Reference Values

Only orderable as a reflex. For further information see:

PAVAL / Paraneoplastic, Autoantibody Evaluation, Serum

ENS2 / Encephalopathy, Autoimmune/Paraneoplastic Evaluation, Serum

MDS2 / Movement Disorder, Autoimmune/Paraneoplastic Evaluation, Serum

MAS1 / Myelopathy, Autoimmune/Paraneoplastic Evaluation, Serum

AIAES / Axonal Neuropathy, Autoimmune/Paraneoplastic Evaluation, Serum

 

<1:240

Neuron-restricted patterns of IgG staining that do not fulfill criteria for Purkinje cell cytoplasmic antibody type 1 may be reported as "unclassified antineuronal IgG." Complex patterns that include nonneuronal elements may be reported as "uninterpretable."

Interpretation

Purkinje cell antibody type 1 (PCA-1) has not been found in any healthy subject. It is rarely found in patients with neurologic diseases (including cerebellar disorders) without gynecologic or breast cancer. The ovarian cancers found in these patients are typically limited in metastatic spread and may not be detected by imaging procedures. If mammography is negative, exploratory laparotomy is advisable (as a "second look" in management of ovarian carcinoma). Breast carcinoma may coexist with a Mullerian cancer. PCA-1 is rarely found in patients with gynecologic cancer without neurologic dysfunction (<2%). PCA-1 is readily distinguished from PCA-Tr (a marker of Hodgkin lymphoma) and PCA-2 (a marker of small-cell lung carcinoma) by standardized staining criteria. PCA-1 rarely, if ever, has accompanying neuronal cytoplasmic or nuclear antibodies.

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 Jul 18;4(5):e385. doi: 10.1212/NXI.0000000000000385)

Day(s) Performed

Monday through Sunday

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

86256

LOINC Code Information

Test ID Test Order Name Order LOINC Value
PC1TS PCA-1 Titer, S 94350-6

 

Result ID Test Result Name Result LOINC Value
43437 PCA-1 Titer, S 94350-6