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22156 Acetylcholine Receptor Binding Ab (ARBI)

Acetylcholine Receptor Binding Ab (ARBI)
Test Code: ACRB
Synonyms/Keywords
Acetylcholine Receptor (Muscle AChR) Antibodies, AChR (Acetylcholine Receptor), Anti -Neuromuscular Junction Receptor Antibodies, Myasthenia Gravis Antibodies
Useful For
 A first-order test for the laboratory diagnosis of myasthenia gravis (MG)
 
Detecting "subclinical MG" in recipients of D-penicillamine, in patients with thymoma without clinical evidence of MG, and in patients with graft-versus-host disease
 
Distinguishing acquired disease (90% positive) from congenital disease (negative)
 
Monitoring disease progression in MG or response to immunotherapy
 
An adjunct to the test for P/Q-type calcium channel binding antibodies as a diagnostic aid for Lambert-Eaton myasthenic syndrome (LES) or primary lung carcinoma
Specimen Requirements
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​Serum Red Top Tube (RTT)​ Serum Separator Tube (SST)​ 1.5 mL​ 1.0 mL​
Acceptable Specimen Types
Patient Preparation: This test should not be requested in patients who have recently received radioisotopes, therapeutically or diagnostically, because of potential assay interference. The specific waiting period before specimen collection will depend on the isotope administered, the dose given and the clearance rate in the individual patient. Specimens will be screened for radioactivity prior to analysis. Radioactive specimens received in the laboratory will be held 1 week and assayed if sufficiently decayed, or canceled if radioactivity remains.
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
Performing Laboratory Information
Performing Location Day(s) Test Performed Analytical Time Methodology/Instrumentation
Mayo Clinic Laboratories
Monday through Sunday​ 3 days​
Radioimmunoassay (RIA)​
Reference Lab
Reference Range Information
< or = 0.02 nmol/L
Interpretation
​Values >0.02 nmol/L are consistent with a diagnosis of acquired myasthenia gravis (MG), provided that clinical and electrophysiological criteria support that diagnosis.
 
The assay for muscle acetylcholine receptor (AChR) binding antibodies is positive in approximately 90% of nonimmunosuppressed patients with generalized MG.
 
The frequency of antibody detection is lower in MG patients with weakness clinically restricted to ocular muscles (71%), and antibody titers are generally low in ocular MG (eg, 0.03-1.0 nmol/L).
 
Results may be negative in the first 12 months after symptoms of MG appear or during immunosuppressant therapy.
Note: In follow up of seronegative patients with adult-acquired generalized MG, 17.4% seroconvert to positive at 12 months (ie, seronegativity rate at 12 months is 8.4%). Of persistently seronegative patients, 38% have muscle-specific kinase (MuSK) antibody.
 
Sera of nonmyasthenic subjects bind per liter 0.02 nmol or less of muscle AChR complexed with (125)I-labeled-alpha-bungarotoxin.
 
In general, there is not a close correlation between antibody titer and severity of weakness, but in individual patients, clinical improvement is usually accompanied by a decrease in titer.
Outreach CPTs
CPT Modifier
(if needed)
Quantity Description Comments
​83519
Synonyms/Keywords
Acetylcholine Receptor (Muscle AChR) Antibodies, AChR (Acetylcholine Receptor), Anti -Neuromuscular Junction Receptor Antibodies, Myasthenia Gravis Antibodies
Ordering Applications
Ordering Application Description
​Centricity ​Acetyl Recep. Bind Ab
​Cerner ​Acetylcholine Receptor Binding Antibody (ARBI)
​COM ​Acetyl Recep.Bind.Ab
If the ordering application you are looking for is not listed, contact your local laboratory for assistance.
Specimen Requirements
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​Serum Red Top Tube (RTT)​ Serum Separator Tube (SST)​ 1.5 mL​ 1.0 mL​
Acceptable Specimen Types
Patient Preparation: This test should not be requested in patients who have recently received radioisotopes, therapeutically or diagnostically, because of potential assay interference. The specific waiting period before specimen collection will depend on the isotope administered, the dose given and the clearance rate in the individual patient. Specimens will be screened for radioactivity prior to analysis. Radioactive specimens received in the laboratory will be held 1 week and assayed if sufficiently decayed, or canceled if radioactivity remains.
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
Useful For
 A first-order test for the laboratory diagnosis of myasthenia gravis (MG)
 
Detecting "subclinical MG" in recipients of D-penicillamine, in patients with thymoma without clinical evidence of MG, and in patients with graft-versus-host disease
 
Distinguishing acquired disease (90% positive) from congenital disease (negative)
 
Monitoring disease progression in MG or response to immunotherapy
 
An adjunct to the test for P/Q-type calcium channel binding antibodies as a diagnostic aid for Lambert-Eaton myasthenic syndrome (LES) or primary lung carcinoma
Reference Range Information
< or = 0.02 nmol/L
Interpretation
​Values >0.02 nmol/L are consistent with a diagnosis of acquired myasthenia gravis (MG), provided that clinical and electrophysiological criteria support that diagnosis.
 
The assay for muscle acetylcholine receptor (AChR) binding antibodies is positive in approximately 90% of nonimmunosuppressed patients with generalized MG.
 
The frequency of antibody detection is lower in MG patients with weakness clinically restricted to ocular muscles (71%), and antibody titers are generally low in ocular MG (eg, 0.03-1.0 nmol/L).
 
Results may be negative in the first 12 months after symptoms of MG appear or during immunosuppressant therapy.
Note: In follow up of seronegative patients with adult-acquired generalized MG, 17.4% seroconvert to positive at 12 months (ie, seronegativity rate at 12 months is 8.4%). Of persistently seronegative patients, 38% have muscle-specific kinase (MuSK) antibody.
 
Sera of nonmyasthenic subjects bind per liter 0.02 nmol or less of muscle AChR complexed with (125)I-labeled-alpha-bungarotoxin.
 
In general, there is not a close correlation between antibody titer and severity of weakness, but in individual patients, clinical improvement is usually accompanied by a decrease in titer.
For more information visit:
Performing Laboratory Information
Performing Location Day(s) Test Performed Analytical Time Methodology/Instrumentation
Mayo Clinic Laboratories
Monday through Sunday​ 3 days​
Radioimmunoassay (RIA)​
Reference Lab
For billing questions, see Contacts
Outreach CPTs
CPT Modifier
(if needed)
Quantity Description Comments
​83519
For most current information refer to the Marshfield Laboratory online reference manual.