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24931 Ganglioside Antibody Panel, Serum (GM1B)

Ganglioside Antibody Panel, Serum (GM1B)
Test Code: GANGPSO
Synonyms/Keywords
​Anti-GM1 Antibody, Asialo GM-1 Antibody, Disialo GD1b, GM1 Antibody Panel, Monosialo GM-1 Antibody, GA1
Test Components
Reflex titers will be performed as needed.
 
IgG Monosialo GM1 Titer
IgM monosialo GM1 Titer
IgG asialo GM1 Titer
IgM asialo GM1 Titer
IgG disialo GD1b Titer
IgM disialo GD1b Titer
Useful For
Supporting diagnosis of an autoimmune neuropathy
Specimen Requirements
 
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
Serum​ ​Red Top Tube (RTT) ​Serum Separator Tube (SST) ​1.0 mL 0.5 mL
Collection Processing Instructions
Spin down primary collection tube and submit serum in a plastic vial.
Specimen Stability Information
Specimen Type Temperature Time
​Serum ​ ​ ​Refrigerated (preferred) ​28 days
​Ambient 72 hours
​Frozen ​28 days
Rejection Criteria
Gross Hemolysis
Gross Lipemia
​Gross Icterus
Interference

​Positive titer values less than 1:16,000 may be found in motor neuron disease, monoclonal gammopathy of uncertain significance (MGUS), and healthy individuals. High titers are very specific of an autoimmune neuropathy.

This test is not diagnostic and should be interpreted in the appropriate clinical context.

This test does not include testing for GD1a or GQ1b autoantibodies.

Performing Laboratory Information
 
Performing Location Day(s) Test Performed Analytical Time Methodology/Instrumentation
​Mayo Clinic Laboratories Tuesday, Thursday ​5-8 days
Enzyme-Linked Immunosorbent Assay (ELISA)​
Reference Lab
Test Information

Neuropathy patients have variable sensory disturbance (loss or exaggerated sensation including with pain), weakness and autonomic involvements (sweat abnormalities, gastrointestinal dysfunction, and lightheadedness on standing). These symptoms are a result of injury to the distal nerves, roots, and ganglia or their gathering points (nerve plexus in the thighs and arms). Patients may have symmetric or asymmetric involvements of the extremities, trunk, and head including extraocular muscles. Subacute onsets and asymmetric involvements favor inflammatory or immune causes over inherited or metabolic forms. Depending on the specific inflammatory or immune mediated causes other parts of the nervous system may also be affected (brain, cerebellum, spinal cord). Nerve conductions and needle electromyography can help to classify the neuropathy as either: 1) primary axonal; 2) primary demyelinating; or 3) mixed axonal and demyelinating.

Among the immune-mediated peripheral neuropathies, autoantibodies to gangliosides represent an important class of noncancer-associated autoimmune peripheral neuropathies. Gangliosides are glycosphingolipids that contain sialic acid and are present in many cell types most abundantly within neural tissues along their linings (myelin). Depending on the specific ganglioside autoantibody found and the antibody titer, in the appropriate clinical context, these findings may be supportive of a specific clinical diagnosis and may also be prognostic for treatment response.

Specifically, in multifocal motor neuropathy (MMN) and multifocal acquired demyelinating sensory and motor (MADSAM) neuropathy, also known as Lewis-Sumner syndrome or multifocal chronic immune demyelinating polyradiculoneuropathy (CIDP), the presence ganglioside autoantibodies, particularly high-titer GM1-IgM autoantibodies, maybe supportive of the diagnosis in the correct clinical context. Furthermore, ganglioside seropositivity has been associated with favorable response to immunotherapy amongst patients suspected to have MMN during the initial clinical evaluation.

Additionally, the presence of ganglioside antibodies may support a diagnosis of Guillain-Barre syndrome (GBS) in the appropriate clinical context. GBS is one class of autoimmune peripheral neuropathies, and comprises a spectrum of disorders including acute inflammatory demyelinating polyradiculoneuropathy, acute motor axonal neuropathy, and acute motor and sensory axonal neuropathy. This class of autoimmune neuropathies is generally characterized by an acute onset. Although the diagnosis of these disorders is dependent on clinical evaluation and electrophysiologic studies, assessment of ganglioside antibodies can further support the diagnosis.

Reference Range Information
Profile Information:
IGG_M: Negative
IGM_M: Negative
IGG_A: Negative
IGM_A: Negative
IGG_D: Negative
IGM_D: Negative
 
Reflex Information:
IGMTS: <1:2000
IMMTS: <1:4000
IGATS: <1:16000
IMATS: <1:8000
IGDTS: <1:2000
IMDTS: <1:2000
Interpretation

 High titers (>1:8,000) favor the diagnosis of multifocal motor neuropathy (MMN) and multifocal acquired demyelinating sensory and motor (MADSAM) over motor neuron disease. About 30% to 50% of patients with these clinical syndromes or the pure motor variant of chronic inflammatory demyelinating polyneuropathy have ganglioside autoantibodies. High-antibody titers appear to be a specific, but not sensitive, marker of those related disorders.

Outreach CPTs
 
CPT Modifier
(if needed)
Quantity Description Comments
​83516​ ​6 Ganglioside Antibody Panel, Serum (GM1B)
​83520 ​1-​6 ​Reflexed testing ​As needed
Synonyms/Keywords
​Anti-GM1 Antibody, Asialo GM-1 Antibody, Disialo GD1b, GM1 Antibody Panel, Monosialo GM-1 Antibody, GA1
Test Components
Reflex titers will be performed as needed.
 
IgG Monosialo GM1 Titer
IgM monosialo GM1 Titer
IgG asialo GM1 Titer
IgM asialo GM1 Titer
IgG disialo GD1b Titer
IgM disialo GD1b Titer
Ordering Applications
Ordering Application Description
​Centricity ​Ganglioside Antibody Panel (83189)
​Cerner ​Ganglioside Antibody Panel (83189)
If the ordering application you are looking for is not listed, contact your local laboratory for assistance.
Specimen Requirements
 
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
Serum​ ​Red Top Tube (RTT) ​Serum Separator Tube (SST) ​1.0 mL 0.5 mL
Collection Processing
Spin down primary collection tube and submit serum in a plastic vial.
Specimen Stability Information
Specimen Type Temperature Time
​Serum ​ ​ ​Refrigerated (preferred) ​28 days
​Ambient 72 hours
​Frozen ​28 days
Rejection Criteria
Gross Hemolysis
Gross Lipemia
​Gross Icterus
Interference

​Positive titer values less than 1:16,000 may be found in motor neuron disease, monoclonal gammopathy of uncertain significance (MGUS), and healthy individuals. High titers are very specific of an autoimmune neuropathy.

This test is not diagnostic and should be interpreted in the appropriate clinical context.

This test does not include testing for GD1a or GQ1b autoantibodies.

Useful For
Supporting diagnosis of an autoimmune neuropathy
Test Components
Reflex titers will be performed as needed.
 
IgG Monosialo GM1 Titer
IgM monosialo GM1 Titer
IgG asialo GM1 Titer
IgM asialo GM1 Titer
IgG disialo GD1b Titer
IgM disialo GD1b Titer
Reference Range Information
Profile Information:
IGG_M: Negative
IGM_M: Negative
IGG_A: Negative
IGM_A: Negative
IGG_D: Negative
IGM_D: Negative
 
Reflex Information:
IGMTS: <1:2000
IMMTS: <1:4000
IGATS: <1:16000
IMATS: <1:8000
IGDTS: <1:2000
IMDTS: <1:2000
Interpretation

 High titers (>1:8,000) favor the diagnosis of multifocal motor neuropathy (MMN) and multifocal acquired demyelinating sensory and motor (MADSAM) over motor neuron disease. About 30% to 50% of patients with these clinical syndromes or the pure motor variant of chronic inflammatory demyelinating polyneuropathy have ganglioside autoantibodies. High-antibody titers appear to be a specific, but not sensitive, marker of those related disorders.

For more information visit:
Performing Laboratory Information
 
Performing Location Day(s) Test Performed Analytical Time Methodology/Instrumentation
​Mayo Clinic Laboratories Tuesday, Thursday ​5-8 days
Enzyme-Linked Immunosorbent Assay (ELISA)​
Reference Lab
For billing questions, see Contacts
Outreach CPTs
 
CPT Modifier
(if needed)
Quantity Description Comments
​83516​ ​6 Ganglioside Antibody Panel, Serum (GM1B)
​83520 ​1-​6 ​Reflexed testing ​As needed
For most current information refer to the Marshfield Laboratory online reference manual.