Neuroimmunology Laboratory Centre of Excellence

Neuroimmunology laboratory under the department of neurology at Amrita Hospital, Kochi is the first of its kind in India- a dedicated comprehensive testing facility for autoimmune neurological disorders under a trained clinical autoimmune neurologist. These disorders can be associated with a cancer (paraneoplastic) as well without cancer association (non-paraneoplastic).    

If properly investigated and diagnosed as an autoimmune neurological syndrome, it becomes potentially treatable and often fully reversible. Here comes the importance of comprehensive neuroimmunology service which can provide an early diagnosis.

We would like to inform you that the following tests- 

1. Ganglioside antibody evaluation panel in Serum by Indirect ELISA
2. Ganglioside antibody evaluation panel in Serum IgG and IgM Mix (GanglioCombi) have been resumed with price revision. Please enquire on our on-call number regarding further details.

Address: Dr.Sudheeran Kannoth, Neuroimmunology laboratory (T6F3) Amrita Institute of Medical Sciences(Amrita Hospital), Ponekkara PO 682041, or Elamakkara PO 682026 Kochi, Kerala, India
Phone:+91 484 285 1234, 0484 6681234 Extension - 6304 & 6318
Mobile: 09400998656
Email: [email protected]

"ZeiniX Life Sciences is the official industry partner of the Neuroimmunology Laboratory at Amrita Institute of Medical Sciences, Cochin. For all commercial inquiries including MoUs and sending samples, please contact ZeiniX at [email protected] or +91 88677 59300. No other laboratory, company or individual is authorized to collect samples on our behalf."

Our aim is to provide a world class testing facility, define the spectrum of these disorders in our country as well as to disseminate information among the physician community. We are planning to develop a nationwide registry for autoimmune neurological disorders and to develop a bio bank for these disorders in collaborations with physicians and institutions across the country.     

When to suspect autoimmune etiology?

Here is a rough guideline about when to suspect an autoimmune neurological disorder-The clinical presentation can range from encephalitis, seizures, cognitive decline, optic neuritis, stroke like episodes, behavioral symptoms like psychosis, brainstem encephalitis characterized by cranial nerve and pyramidal involvement, ataxia, movement disorders like chorea and myoclonus ,dyskinesias, cerebellar ataxia, myelopathy, plexopathy, radiculopathy, neuropathy, autonomic neuropathy, myopathy and neuromuscular conduction defect-myasthenia.

Though the classical description of VGKC is limbic encephalitis and Moorvan's syndrome, the other presentations like PCD, GI dysmotility, parkinsonism, tremor, chorea, sensory motor neuropathy, hyponatremias, dyssomnia , hyperphagia, facio brachial dystonic seizure, other seizures and presentation mimicking CJD are well described. NMDA receptor antibodies classically associated with Psychiatric features and memory loss, orofacial dyskinesia, choreoathetoid movements, abnormal posturing or increased tone, catatonic state and central hypoventilation.

NMO IgG has expanded the spectrum of NMO to include optic neuritis and myelitis into NMO spectrum of disorder without the classical presentation of eye and spine involvement.     
 

Autoimmune etiology should be strongly sought in all neurological syndromes of unexplained etiology.

Paraneoplastic/autoimmune etiology should be considered in subacute sensory neuronopathy, cerebellar ataxia, limbic encephalitis, opsoclonus/myoclonus, encephalomyelitis, chronic gastrointestinal pseudo-obstruction and Lambert Eaton myasthenic syndrome.

Paraneoplastic antibodies are cancer specific, not disease-specific. Hence we discourage testing for single antibodies in the panel. Sometimes same patient can have multiple antibodies which in fact help us to locate cancer easily.

 *Reflex to titer assay

End point titer will be performed at an additional charge upon request from your treating consultant.

Purpose of recommendation for Reflex to titer assay in antibody-positive cases.

1.Reflex to titer is a measure of the amount of antibody in serum and CSF; the higher the titer, the higher the autoantibodies present in the samples.
 

2.Reflex-to-titer assay is used in monitoring treatment response in autoantibody-positive patients. Decreasing antibody titer may be associated with good therapeutic response, so clinical correlation must be strongly considered.

* Laboratory working time 9.00 am to 6.00 pm. (Except Sundays and Institute Holidays)

Specimen: Serum (Volume Two ml)      Specimen: CSF (Volume One ml)

CSF Sample collection in sterile leak proof, polypropylene/ plastic tube

Serum collection in 5 ml blood in Red cap vacutainer(Clotted blood) or yellow cap(Gel)

Sample Retention Policy: CSF and Serum samples retained for 30 days only.
 

Method of sample transportation

1. Use a screw top, leak proof polypropylene/ plastic tube for CSF(2-3ml). Blood (5ml) to be collected in Red cap vacutainer (Clotted blood) or yellow cap(Gel) tube.
2. Sample is stable at ambient temperature for 72 hours.
3. Samples sent by courier, should reach the lab within 72 hours.
4. Avoid sending the sample at weekends to reduce the transport time to less than 72 hours.
5. Store sample in a refrigerator until sending
6. If any delay is expected, ensure cold chain is maintained. To ensure the integrity of serum and cerebrospinal fluid (CSF) samples during transport, use leak-proof, sterile, and clearly labelled primary containers (such as blood tubes for serum and sterile screw-cap, leak proof polypropylene/ plastic tube tubes for CSF), placed inside a sealed secondary container with absorbent material, and then within an insulated tertiary container (cold box) with ice or gel packs to maintain a temperature of 2–8°C, avoiding direct contact between the sample and cooling elements.
7. In case of small sample volume or any other problem, contact lab before sending.
    

Please ensure samples are accompanied by completely filled Test Request Form (TRF) along with payment details. Avoid sending samples of different patients together. Separate them by using different Zip lock pouches.

Payment options

1.Cash payment at the Billing Counter at Amrita Institute of Medical Sciences directly

2.*Demand Draft in favor of Amrita Institute of Medical Sciences payable at Kochi/ Ernakulam
3.*Online / Internet Fund Transfer National Electronic Fund Transfer (NEFT)

Account Name: Amrita Institute of Medical Sciences and Research Centre

Account No: 015500100001304

Address:Amrita Lane, AIMS Ponekkara.P.O., Ernakulam, Kerala State, India. Pin Code: 682041

Bank Name: The Dhanalakshmi Bank Limited, AIMS Campus, Amrita Lane, AIMS Ponekkara.P.O, Ernakulam, Kerala State, India. Pin Code 682041.

Bank SWIFT Code:DLXBINBB

Bank RTGS/IFSC Code:DLXB0000155

*Please provide DD details/Bank transaction ID details with test request form.

Bank Transfer details

Reference :- Patient Name and MRD No

Transfer details required for accounting purpose

Senders Name

Senders Bank Name

Date of transaction

Place of Senders

bank Amount of

Transfer

UTR No and transaction ID

Details submitted by

Patient Name and MRD No:-

Details submitted by

After transaction kindly send the UTR number / Transaction Number to these mail id neuroimmunology @aims.amrita .edu and [email protected] and [email protected]

• http://www.pnseuronet.org/
• http://www.esni.org/
• http://www.birmingham.ac.uk/facilities/clinical-immunology-services/neuroimmunology/index.aspx
• http://www.isniweb.org/