Test Code PVLE Paraneoplastic Vision Loss Evaluation, Serum
Ordering Guidance
Multiple neurological phenotype-specific autoimmune/paraneoplastic evaluations are available. For more information as well as phenotype-specific testing options, refer to Autoimmune Neurology Test Ordering Guide.
For a list of antibodies performed with each evaluation, see Autoimmune Neurology Antibody Matrix.
Necessary Information
Provide the following information:
-Relevant clinical information
-Ordering provider name, phone number, mailing address, and e-mail address
Specimen Required
Patient Preparation:
1. For optimal antibody detection, specimen collection is recommended prior to initiation of immunosuppressant medication.
2. This test should not be requested for patients who have recently received radioisotopes, therapeutically or diagnostically, because of potential assay interference. The specific waiting period before specimen collection will depend on the isotope administered, the dose given, and the clearance rate in the individual patient. Specimens will be screened for radioactivity prior to analysis. Radioactive specimens received in the laboratory will be held 1 week and assayed if sufficiently decayed or canceled if radioactivity remains.
Supplies: Sarstedt Aliquot Tube, 5 mL (T914)
Collection Container/Tube:
Preferred: Red top
Acceptable: Serum gel
Submission Container/Tube: Plastic vial
Specimen Volume: 4 mL
Collection Instructions: Centrifuge and aliquot serum into a plastic vial.
Useful For
Evaluating patients with rapidly progressive vision loss where a paraneoplastic cause for vision loss (retinopathy or optic neuritis with other findings [eg, retinitis] is suspected)
Evaluating patients with small-cell carcinoma who develop vision loss
Profile Information
Test ID | Reporting Name | Available Separately | Always Performed |
---|---|---|---|
PVLEI | Paraneoplas Vision Loss Interp, S | No | Yes |
CRMS | CRMP-5-IgG, S | No | Yes |
RCVBS | Recoverin Immunoblot, S | Yes | Yes |
Reflex Tests
Test ID | Reporting Name | Available Separately | Always Performed |
---|---|---|---|
CRMWS | CRMP-5-IgG Western Blot, S | Yes | No |
CRMTS | CRMP-5-IgG Titer, S | No | No |
Testing Algorithm
If the indirect immunofluorescence assay (IFA) patterns suggest collapsin response-mediator protein-5 (CRMP-5) antibody, then CRMP-5 IFA titer and CRMP-5 Western blot will be performed at an additional charge.
Method Name
PVLEI: Medical Interpretation
CRMTS, CRMS: Indirect Immunofluorescence Assay (IFA)
CRMWS: Western Blot (WB)
RCVBS: Immunoblot (IB)
Reporting Name
Paraneoplastic Vision Loss Eval, SSpecimen Type
SerumSpecimen Minimum Volume
2 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 |
Reference Values
COLLAPSIN RESPONSE-MEDIATOR PROTEIN-5-IgGNegative
RECOVERIN IMMUNOBLOT
Negative
COLLAPSIN RESPONSE-MEDIATOR PROTEIN-5 TITER
<1:240
COLLAPSIN RESPONSE-MEDIATOR PROTEIN-5 WESTERN BLOT
Negative
Titers lower than 1:240 are detectable by recombinant CRMP-5 Western blot analysis. CRMP-5 Western blot analysis will be done on request on stored serum (held 4 weeks). This supplemental testing is recommended in cases of chorea, vision loss, cranial neuropathy, and myelopathy. Call 1-800-533-1710 to request CRMP-5 Western blot. Neuron-restricted patterns of IgG staining that do not fulfill criteria for CRMP-5-IgG may be reported as "unclassified antineuronal IgG." Complex patterns that include non-neuronal elements may be reported as "uninterpretable."
Performing Laboratory
Mayo Clinic Laboratories in RochesterTest 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 x1
84182 x1
84182 CRMWS (if appropriate)
86256 CRMTS (if appropriate)
LOINC Code Information
Test ID | Test Order Name | Order LOINC Value |
---|---|---|
PVLE | Paraneoplastic Vision Loss Eval, S | 104992-3 |
Result ID | Test Result Name | Result LOINC Value |
---|---|---|
83077 | CRMP-5-IgG, S | 72504-4 |
610009 | Recoverin Immunoblot, S | 83003-4 |
607411 | Paraneoplas Vision Loss Interp, S | 104993-1 |
618908 | IFA Notes | 48767-8 |
Forms
If not ordering electronically, complete, print, and send a Neurology Specialty Testing Client Test Request (T732) with the specimen.
Day(s) Performed
Profile tests: Monday through Sunday; Reflex tests: Varies