Anti gad 65 is >1:2400 and says positive. in footnotes, it mentions paraneoplastic disorder. what are best next steps?

Ordering physician?: Ask the ordering physician. Depends why the test was ordered to begin with. Paraneoplastic syndromes are caused by a neoplastic process; it may be a concern if one has diagnosis of cancer. Anti-gad may be seen in association with paraneoplastic syndromes involving the nervous system. Note that the majority of patients with antibodies to gad do not have cancer. Discuss with ordering physician.