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26077 CNS Demyelinating Disease Evaluation (CDS1)

CNS Demyelinating Disease Evaluation (CDS1)
Test Code: CDS1SO
Synonyms/Keywords

​ADEM
AQP4
Aquaporin
Devic's Antibody
NMO (Neruomyelitis Optica)
NMO-IgG
Optic Neuritis Antibody
Transverse Myelitis Antibody
Vision Loss Antibody

Test Components
​CNS Demyelinating Disease Interpretation
NMOFS NMO/AQP4 FACS
MOGFS MOG FACS
 
Reflex Tests:
NMO/AQP4 FACS Titer
MOG FACS Titer
Useful For
​Diagnosis of inflammatory demyelinating diseases (IDD) with similar phenotype to
neuromyelitis optica spectrum disorder (NMOSD), including optic neuritis (single or bilateral) and
transverse myelitis.
Diagnosis of autoimmune myelin oligodendrocyte glycoprotein (MOG)-opathy.
Diagnosis of neuromyelitis optica (NMO).
Distinguishing NMOSD, acute disseminated encephalomyelitis (ADEM), optic neuritis, and transverse
myelitis from multiple sclerosis early in the course of disease.
Diagnosis of ADEM.
Prediction of a relapsing disease course.
Specimen Requirements
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​No ​Serum ​Red Top Tube (RTT) ​Serum Separator Tube (SST) ​3.0 mL ​2.0 mL
Collection Processing Instructions
For optimal antibody detection, drawing the specimen before initiation of immunosuppressant medication is recommended.
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

​Aquaporin-4 (AQP4)-IgG and myelin oligodendrocyte glycoprotein (MOG)-IgG antibodies may drop below detectable levels in setting of therapies for acute attack (IV methylprednisolone or plasmapheresis) or attack prevention (immunosuppressants).

Performing Laboratory Information
Performing Location Day(s) Test Performed Report Available Methodology/Instrumentation
​Mayo Clinic Laboratories ​Monday, Tuesday, Thursday ​7 to 10 days ​Flow Cytometry
Reference Lab
Test Information
This test was developed and its performance characteristics determined by Mayo Medical Laboratories. 
Reference Range Information
MOG FACS
Negative
Reference values apply to all ages.
 
NMO/AQP4 FACS
Negative
Reference values apply to all ages.
Interpretation

A positive value for aquaporin-4 (AQP4)-IgG is consistent with an autoimmune astrocytopathy/neuromyelitis optica spectrum disorder (NMOSD) and justifies initiation of appropriate immunosuppressive therapy at the earliest possible time. This allows early initiation and maintenance of optimal therapy. Recommend follow-up in 3 to 6 months if NMOSD is suspected.

A positive value for myelin oligodendrocyte glycoprotein (MOG)-IgG is consistent with an neuromyelitis optica (NMO)-like phenotype, and in the setting of acute disseminated encephalomyelitis (ADEM), optic neuritis (ON) and transverse myelitis (TM) indicates an autoimmune oligodendrogliopathy with potential for relapsing course. Identification of MOG-IgG allows distinction from multiple sclerosis (MS) and may justify initiation of appropriate immunosuppressive therapy (not MS disease-modifying agents) at the earliest possible time. This allows early initiation and maintenance of optimal therapy. Recommend follow-up in 3 to 6 months as persistence of MOG-IgG seropositivity predicts a relapsing course.

Detection of both antibodies is rare and unusual.

AQP4-IgG and MOG-IgG are not found in MS or healthy subjects.

Outreach CPTs
CPT Modifier
(if needed)
Quantity Description Comments
86255​ ​2 ​NMO/AQP4 FACS and MOG FACS
​86256 ​1 ​NMO FACS Titer ​If appropriate
​86256 ​1 ​MOG FACS Titer ​If appropriate
Classification
This test was developed and its performance characteristics determined by Mayo Medical Laboratories. 
Synonyms/Keywords

​ADEM
AQP4
Aquaporin
Devic's Antibody
NMO (Neruomyelitis Optica)
NMO-IgG
Optic Neuritis Antibody
Transverse Myelitis Antibody
Vision Loss Antibody

Test Components
​CNS Demyelinating Disease Interpretation
NMOFS NMO/AQP4 FACS
MOGFS MOG FACS
 
Reflex Tests:
NMO/AQP4 FACS Titer
MOG FACS Titer
Ordering Applications
Ordering Application Description
​Centricity ​CNS Demyelinating Disease Evaluation (CDS1)
​Cerner ​CNS Demyelinating Disease Evaluation (CDS1)
​COM ​CNS Demyelinating Disease Evaluation (CDS1)
If the ordering application you are looking for is not listed, contact your local laboratory for assistance.
Specimen Requirements
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​No ​Serum ​Red Top Tube (RTT) ​Serum Separator Tube (SST) ​3.0 mL ​2.0 mL
Collection Processing
For optimal antibody detection, drawing the specimen before initiation of immunosuppressant medication is recommended.
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

​Aquaporin-4 (AQP4)-IgG and myelin oligodendrocyte glycoprotein (MOG)-IgG antibodies may drop below detectable levels in setting of therapies for acute attack (IV methylprednisolone or plasmapheresis) or attack prevention (immunosuppressants).

Useful For
​Diagnosis of inflammatory demyelinating diseases (IDD) with similar phenotype to
neuromyelitis optica spectrum disorder (NMOSD), including optic neuritis (single or bilateral) and
transverse myelitis.
Diagnosis of autoimmune myelin oligodendrocyte glycoprotein (MOG)-opathy.
Diagnosis of neuromyelitis optica (NMO).
Distinguishing NMOSD, acute disseminated encephalomyelitis (ADEM), optic neuritis, and transverse
myelitis from multiple sclerosis early in the course of disease.
Diagnosis of ADEM.
Prediction of a relapsing disease course.
Test Components
​CNS Demyelinating Disease Interpretation
NMOFS NMO/AQP4 FACS
MOGFS MOG FACS
 
Reflex Tests:
NMO/AQP4 FACS Titer
MOG FACS Titer
Reference Range Information
MOG FACS
Negative
Reference values apply to all ages.
 
NMO/AQP4 FACS
Negative
Reference values apply to all ages.
Interpretation

A positive value for aquaporin-4 (AQP4)-IgG is consistent with an autoimmune astrocytopathy/neuromyelitis optica spectrum disorder (NMOSD) and justifies initiation of appropriate immunosuppressive therapy at the earliest possible time. This allows early initiation and maintenance of optimal therapy. Recommend follow-up in 3 to 6 months if NMOSD is suspected.

A positive value for myelin oligodendrocyte glycoprotein (MOG)-IgG is consistent with an neuromyelitis optica (NMO)-like phenotype, and in the setting of acute disseminated encephalomyelitis (ADEM), optic neuritis (ON) and transverse myelitis (TM) indicates an autoimmune oligodendrogliopathy with potential for relapsing course. Identification of MOG-IgG allows distinction from multiple sclerosis (MS) and may justify initiation of appropriate immunosuppressive therapy (not MS disease-modifying agents) at the earliest possible time. This allows early initiation and maintenance of optimal therapy. Recommend follow-up in 3 to 6 months as persistence of MOG-IgG seropositivity predicts a relapsing course.

Detection of both antibodies is rare and unusual.

AQP4-IgG and MOG-IgG are not found in MS or healthy subjects.

For more information visit:
Performing Laboratory Information
Performing Location Day(s) Test Performed Report Available Methodology/Instrumentation
​Mayo Clinic Laboratories ​Monday, Tuesday, Thursday ​7 to 10 days ​Flow Cytometry
Reference Lab
For billing questions, see Contacts
Outreach CPTs
CPT Modifier
(if needed)
Quantity Description Comments
86255​ ​2 ​NMO/AQP4 FACS and MOG FACS
​86256 ​1 ​NMO FACS Titer ​If appropriate
​86256 ​1 ​MOG FACS Titer ​If appropriate
Classification
This test was developed and its performance characteristics determined by Mayo Medical Laboratories. 
For most current information refer to the Marshfield Laboratory online reference manual.