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Test ID ROC Rubeola (Measles) Antibodies, IgG and IgM (Separate Determinations), Spinal Fluid

Reporting Name

Rubeola (Measles) Ab, IgG,IgM, CSF

Useful For

Diagnosis of central nervous system infection with rubeola (measles) virus and/or subacute sclerosing panencephalitis

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Specimen Type

CSF


Specimen Required


Container/Tube: Sterile vial

Specimen Volume: 0.25 mL


Specimen Minimum Volume

0.1 mL

Specimen Stability Information

Specimen Type Temperature Time
CSF Refrigerated (preferred) 14 days
  Frozen  14 days

Reference Values

IgG: <1:5

IgM: <1:10

Reference values apply to all ages.

Day(s) and Time(s) Performed

Monday through Friday; 9 a.m.

Test Classification

This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the U.S. Food and Drug Administration.

CPT Code Information

86765 x 2

LOINC Code Information

Test ID Test Order Name Order LOINC Value
ROC Rubeola (Measles) Ab, IgG,IgM, CSF 90254-4

 

Result ID Test Result Name Result LOINC Value
5741 Rubeola (Measles) Ab, IgG 22501-1
5742 Rubeola (Measles) Ab, IgM 22505-2

Clinical Information

Measles is a serious and highly contagious disease that can be a leading cause of death where nutrition and sanitation are limited. Onset begins with cough, fever, and lymphadenopathy approximately 2 weeks after exposure. Diagnosis is usually made when the rash appears. Koplik spots may be seen earlier on the buccal mucosa. Complications of measles may develop in children who appear to have normal immune functions.

 

Persistent infection of the central nervous system with measles virus is recognized to cause the disease subacute sclerosing panencephalitis (SSPE). SSPE is a rare, late complication of measles with an incidence of approximately 1 per 100,000 cases. SSPE is a progressive, usually fatal disease that occurs most often in children between the ages of 5 and 14. The onset is insidious and progressive. The incubation period from acute measles to onset of neurological symptoms varies from several months to many years. One of the most useful diagnostic tests involves the measurement of measles-specific antibodies in the cerebrospinal fluid (CSF) of patients with SSPE. Levels of antibody are significantly elevated in the CSF of SSPE patients compared to those without the disease.

Interpretation

Detection of organism-specific antibodies in the cerebrospinal fluid (CSF) may suggest central nervous system infection. However, these results are unable to distinguish between intrathecal antibodies and serum antibodies introduced into the CSF at the time of lumbar puncture or from a breakdown in the blood-brain barrier. The results should be interpreted with other laboratory and clinical data prior to a diagnosis of central nervous system infection.

 

Patients with subacute sclerosing panencephalitis have serum antibody titers which are 10 to 100 times higher than those seen in late convalescent-phase sera. More importantly, there is pronounced local production of oligoclonal measles virus antibodies in the central nervous system.

Cautions

Detection of organism-specific antibodies in the cerebrospinal fluid (CSF) may suggest central nervous system infection. However, these results are unable to distinguish between intrathecal antibodies and serum antibodies introduced into the CSF at the time of lumbar puncture or from a breakdown in the blood-brain barrier. The results should be interpreted with other laboratory and clinical data prior to a diagnosis of central nervous system infection.

Clinical Reference

Gascon GG: Subacute sclerosing panencephalitis. Semin Pediatr Neurol 1996;3:260-269

Analytic Time

1 day

Reject Due To

Hemolysis

Mild OK; Gross OK

Lipemia

Mild OK; Gross OK

Icterus

NA

Other

NA

NY State Approved

No

Method Name

Immunofluorescence Assay (IFA)

Forms

If not ordering electronically, complete, print, and send a Microbiology Test Request (T244) with the specimen.