Yale New Haven Hospital

Department of Laboratory Medicine
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Neuromyelitis optica autoAb, IgG

Lab Section: 

Sendout Reference


Lab Location: 


Reference Lab: 



Test ID: 




AQP Aquaporin Devic's Antibody NMO-IgG Transverse Myelitis Antibody Optic Neuritis Antibody


Flow Cytometry




5-10 days

Specimen Requirements: 

Collection: 4.0 mL Blood in a Red Top Tube. Acceptable: Serum gel
Pediatric volume: 1 mL.
Transport: Refrigerated.
Stability: Refrigerated 28 days; Frozen 28 days; Ambient 72 hours



Reflex Criteria: If NMO/APQ4 ELISA results are indeterminate (> or =1.6 and < or =4.9 U/mL), NMO-IgG by Indirect Immunofluorescence will be performed at an additional charge.

Clinical Indications: Neuromyelitis optica (NMO, sometimes called Devic disease) is a severe, relapsing, autoimmune, inflammatory and demyelinating central nervous system disease that predominantly affects optic nerves and the spinal cord. The disorder is now recognized as a spectrum of autoimmunity targeting the astrocytic water channel aquaporin-4 (AQP4). NMO spectrum disorders (NMOSD) may involve the brain and brainstem with symptoms of encephalopathy (particularly in children). Prior to introducing a serological biomarker for NMO, the disorder was thought to be confined exclusively to the optic nerves and spinal cord, that the clinical course was monophasic and that NMO was a subset of multiple sclerosis (MS). The discovery of a highly specific disease marker for NMO (NMO-IgG/AQP4-IgG) helped to define the full clinical spectrum of NMOSD and to distinguish these disorders from MS.Detection of AQP4-IgG by enzyme-linked immunosorbent assay allows distinction of NMOSD (65%-77% are positive) from MS (0% positive), and is indicative of a relapsing disease, mandating initiation of immunosuppression, even after the first attack, thereby reducing attack frequency and disability in the future.

Reference Interval: 

See patient report or consult reference laboratory website.


CPT Code(s): 

86255, 86256

Last Changed: 

8/16/2017 6:59:03

Last Reviewed: 

8/28/2017 6:51:08