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Acetylcholine Receptor Modulating Antibody (Southeast Michigan Only)

Myasthenia Gravis (MG), AChR modulating antibody

Test Codes

EPIC: LAB1231688, Beaker: XARMO, ARUP: 99521, MAYO: LAB1230826-Lab Only

Department

Send Outs

Specimen Collection Criteria

Collect (preferred specimen): One Gold-top SST tube.
Also acceptable: One plain Red-top tube.

Physician Office/Draw Specimen Preparation

Let specimen clot 30-60 minutes then centrifuge to separate serum from cells within two hours of collection. Transfer serum to a plastic transport tube and refrigerate (2-8°C or 36-46°F).

Preparation for Courier Transport

Transport: 0.5 mL serum, refrigerated (2-8°C or 36-46°F). (Minimum: 0.3 mL)

Rejection Criteria

• Plasma
• Hemolyzed specimens.
• Severely lipemic specimens.
• Specimens not collected and processed as indicated.

In-Lab Processing

Let specimen clot 30-60 minutes then centrifuge to separate serum from cells within two hours of collection. Transfer serum to a plastic transport tube and refrigerate (2-8°C or 36-46°F).

Transport: 0.5 mL serum, refrigerated (2-8°C or 36-46°F). (Minimum: 0.3 mL)

Storage

Specimen Stability for Testing:

Room Temperature (20-26°C or 68-78.8°F): 2 hours, after centrifugation 48 hours
Refrigerated (2-8°C or 36-46°F): 14 days
Frozen (-20°C/-4°F or below): 1 year

Specimen Storage in Department Prior to Disposal:

Specimen retention time is determined by the policy of the reference laboratory. Contact the Send Outs Laboratory with any questions.

Laboratory

Sent to ARUP Laboratories, Salt Lake City, UT.

Performed

Sunday – Friday.
Results available in 3-8 days.

Reference Range

Negative: 0-45% modulation.
Positive: 46% or greater modulation.

Test Methodology

Semi-Quantitative Flow Cytometry.

Interpretation

Approximately 85-90% of patients with myasthenia gravis (MG) express antibodies to the acetylcholine receptor (AChR), which can be divided into binding, blocking, and modulating antibody. Binding antibody can activate complement and lead to loss of AChR. Blocking antibody may impair AChR binding to the receptor, leading to poor muscle contraction. Modulating antibody causes receptor endocytosis resulting in loss of AChR expression, which correlates most closely with clinical severity of disease. Approximately 10-15% of individuals with confirmed myasthenia gravis have no measurable binding, blocking, or modulating antibody.

CPT Codes

83516

Contacts

Last Updated

10/25/2024