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HelpTest ID: MA2EC Ma2 Antibody, ELISA, Spinal Fluid
Necessary Information
Provide the following information:
1. Relevant clinical information
2. Ordering provider name, phone number, mailing address, and e-mail address
Specimen Required
Container/Tube: Sterile vial
Preferred: Vial number 1
Acceptable: Any vial
Specimen Volume: 2 mL
Useful For
Evaluating patients with suspected paraneoplastic encephalitides using spinal fluid specimens
Method Name
Enzyme-Linked Immunosorbent Assay (ELISA)
Reporting Name
Ma2 Ab ELISA, CSFSpecimen Type
CSFSpecimen Minimum Volume
1 mL
Specimen Stability Information
| Specimen Type | Temperature | Time |
|---|---|---|
| CSF | Refrigerated (preferred) | 28 days |
| Frozen | 28 days | |
| Ambient | 72 hours |
Clinical Information
Ma2 antibodies are IgG biomarkers found in patients with paraneoplastic encephalitis (limbic encephalitis or brainstem encephalitis) or cerebellar ataxia. Antibodies (Ab) to Ma antigens can be found directed at Ma2 alone, or both Ma1 and Ma2, but never Ma1 alone. The accompanying neurological disorders (encephalitis, dementia, brainstem encephalitis, cerebellar ataxia) are usually severe. The cancer associations are either testicular germinoma (Ma2 Ab positive only) or diverse (Ma1 and Ma2 Ab positive). Neurological improvement upon treatment of cancer or immunotherapy is more commonly encountered in those seropositive for Ma2 only than when compared to Ma1 and Ma2 together.
Reference Values
Negative
Interpretation
Seropositivity for Ma2 antibody is consistent with a diagnosis of an autoimmune central nervous system disorder (encephalopathy, dementia, seizure disorder, brainstem encephalitis or cerebellar ataxia). A paraneoplastic basis should be considered and include seminoma (testicular or extra-testicular).
Clinical Reference
1. Voltz R, Gultekin SH, Rosenfeld MR, et al: A serologic marker of paraneoplastic limbic and brain-stem encephalitis in patients with testicular cancer. N Engl J Med. 1999 Jun 10;340(23):1788-1795. doi: 10.1056/NEJM199906103402303
2. Rosenfeld MR, Eichen JG, Wade DF, Posner JB, Dalmau J: Molecular and clinical diversity in paraneoplastic immunity to Ma proteins. Ann Neurol. 2001 Sep;50(3):339-348
3. Dalmau J, Graus F, Villarejo A, et al: Clinical analysis of anti-Ma2-associated encephalitis. Brain. 2004 Aug;127(Pt 8):1831-1844. doi: 10.1093/brain/awh203
4. Schuller M, Jenne D, Voltz R. The human PNMA family: novel neuronal proteins implicated in paraneoplastic neurological disease. J Neuroimmunol. 2005 Dec;169(1-2):172-176. doi: 10.1016/j.jneuroim.2005.08.019
5. Hoffmann LA, Jarius S, Pellkofer HL, et al: Anti-Ma and anti-Ta associated paraneoplastic neurological syndromes: 22 newly diagnosed patients and review of previous cases. J Neurol Neurosurg Psychiatry. 2008 Jul;79(7):767-773. doi: 10.1136/jnnp.2007.118588
6. Kunchok A, McKeon A: Opsoclonus in anti-Ma2 brain-stem encephalitis. N Engl J Med. 2020 Sep 24;383(13):e84. doi: 10.1056/NEJMicm1914516
7. Adams C, McKeon A, Silber MH, Kumar R: Narcolepsy, REM sleep behavior disorder, and supranuclear gaze palsy associated with Ma1 and Ma2 antibodies and tonsillar carcinoma. Arch Neurol. 2011 Apr;68(4):521-4. doi: 10.1001/archneurol.2011.56. Erratum in: Arch Neurol. 2011 Sep;68(9):1211
Day(s) Performed
Tuesday, Friday
Report Available
3 to 5 daysTest 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
83516
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| MA2EC | Ma2 Ab ELISA, CSF | 101867-0 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| 605971 | Ma2 Ab ELISA, CSF | 101867-0 |
Forms
If not ordering electronically, complete, print, and send a Neurology Specialty Testing Client Test Request (T732) with the specimen.
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