Abstract Details

Title Shooting in the Dark? A Single-Center Experience of Neural Autoantibody Panel Testing

Topic Autoimmune Neurology

Presentation(s) P9 - Poster Session 9 (11:45 AM-12:45 PM)

Poster/Presentation
Number 8-009

Objective Determine the frequency of positive results from neural autoantibody panels performed on patients evaluated at the University of Utah Hospitals and Clinics.

Background Clinical reference laboratories offer autoantibody panels used in the diagnosis of rare antibody-associated neurologic conditions including autoimmune encephalitis, stiff-person spectrum disorders, autoimmune epilepsy, and paraneoplastic neurologic syndromes. With increased awareness of autoimmune neurologic diseases, these panels are frequently ordered by diverse medical specialists during the evaluation of patients with unexplained neurologic symptoms, even when the clinical suspicion for an autoimmune cause of symptoms is low.

Design/Methods We collected results from all neural autoantibody panels sent from the University of Utah Hospitals and Clinics to either ARUP or Mayo Clinic Laboratories (the two primary clinical reference laboratories our hospital system contracts with for this testing) from September 1, 2019 to August 31, 2024. We excluded panels that tested specifically for CNS demyelinating disease (AQP4-IgG, MOG-IgG) as well as any single autoantibody tests not sent as part of a panel. A retrospective review of the electronic medical record of patients with any positive result was performed.

Results In total, 1613 Mayo Clinic Laboratories panels (1033 serum and 580 CSF) and 1103 ARUP panels (722 serum and 381 CSF) were performed. Over 85% of neural autoantibody panel testing was negative for all antibodies assessed at either clinical reference laboratory. ARUP panels had a 16% positive rate in serum and 3% positive rate in CSF; Mayo panels had a 22% positive rate in serum and 4% positive rate in CSF. We report the demographics, final diagnoses, and clinical utility of neural autoantibody testing in this cohort.

Conclusions Consideration of pretest probability and consultation with an autoimmune neurologist prior to ordering panel testing can help maximize the yield of autoantibody panels and provide patients with high-value healthcare.

Authors/Disclosures
Jasmine Pascoe, MD (Foothills Neurology) PRESENTER	Dr. Pascoe has nothing to disclose.
Lisa K. Peterson, PhD (ARUP Laboratories)	Dr. Peterson has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Werfen. Dr. Peterson has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Werfen. Dr. Peterson has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for AliveDx. Dr. Peterson has received personal compensation in the range of $0-$499 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Clinical Biochemistry. Dr. Peterson has received personal compensation in the range of $0-$499 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Lab Q for ASCP. Dr. Peterson has a non-compensated relationship as a President with Association of Medical Laboratory Immunologists that is relevant to AAN interests or activities.
Ka-Ho Wong (U of U Neurology Clinic)	The institution of Mr. Wong has received research support from The Sumaira Foundation . The institution of Mr. Wong has received research support from The Siegel Rare Neuroimmune Association.
Stacey Clardy, MD, PhD, FAAN (University of Utah)	Dr. Clardy has received personal compensation for serving as an employee of Veterans Health Administration (VHA). Dr. Clardy has received personal compensation for serving as an employee of University of Utah Health. Dr. Clardy has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for AstraZeneca/Alexion. Dr. Clardy has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Amgen/Horizon. Dr. Clardy has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Arialys. Dr. Clardy has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Kyverna. Dr. Clardy has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Neurology/AAN Publications. The institution of Dr. Clardy has received research support from NIH/NINDS. The institution of Dr. Clardy has received research support from SRNA. The institution of Dr. Clardy has received research support from Alexion/AstraZeneca. Dr. Clardy has received personal compensation in the range of $500-$4,999 for serving as a AAN Summer Meeting CoDirector Travel and Lodging with AAN. Dr. Clardy has received personal compensation in the range of $500-$4,999 for serving as a Grand Rounds Travel/Lodging/Honoraria with U of Iowa, Miami, Stanford, Barrow, Beaumont Health, CCF, Emory, Penn State, Mayo Clinic, Walter Reed.
Tammy L. Smith, MD, PhD (Imaging and Neurosciences Center)	Dr. Smith has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for EMD Serono. The institution of Dr. Smith has received research support from Alexion/AstraZeneca.

��ɫ��

��ɫ��