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Please call 616.774.7721 for specimen pick up

 

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Mayo Clinic Laboratories

Epic Code LAB1231558 Neuronal Nuclear Antibodies

Additional Codes

ARUP: 3002917

Test Name Alias

XNNAB, ANTI-HU, ANTI-RI, ANTI-YO, Neuronal Nuclear Antibodies (Hu, Ri, Yo, Tr/DNER) IgG by Immunoblot, Serum, NRNL IB S

Interface Order Alias

1231558

Clinical Information

Useful for the evaluation of classic paraneoplastic neurologic syndrome.

Collection Instructions

Quick Collect: +(2)S/PO/R - 5 ML GOLD TOP SST R

Tube: Serum separator tube

Specimen Preparation: Separate serum from cells ASAP or within 2 hours of collection. Transfer 1 mL serum to an ARUP standard transport tube. (Min: 0.30 mL)

Storage/Transport Temperature: Refrigerated

Unacceptable Conditions: Plasma. Contaminated, heat-inactivated, grossly hemolyzed, or lipemic specimens

Specimen Stability

After separation from cells:

Ambient: 48 hours

Refrigerated: 2 weeks

Frozen: 1 month

Test Frequency

Test Performed: Mon, Thu, Sat, Reported 1-4 days

Reference Range

  Components Reference Interval
  Purkinje Cell Ab (Yo) IgG, IB, Ser Negative
  Purkinje Cell Ab (TR/DNER) IgG, IB, Ser Negative
  Neuronal Nuclear Ab (Ri) IgG, IB, Serum Negative
  Neuronal Nuclear Ab (Hu) IgG, IB, Serum Negative

Interpretive Data

This test detects IgG antineuronal antibodies to Hu, Ri, Yo and Tr (DNER) antigens.

Antineuronal antibodies serve as markers that aid in discriminating between a true paraneoplastic neurological disorder (PND) and other inflammatory disorders of the nervous system. Anti-Hu (antineuronal nuclear antibody, type I) is associated with small-cell lung cancer. Anti-Ri (antineuronal nuclear antibody, type II) is associated with neuroblastoma in children and with fallopian tube and breast cancer in adults. Anti-Yo (anti-Purkinje cell cytoplasmic antibody) is associated with ovarian and breast cancer. Anti-Tr(DNER) is associated with Hodgkin lymphoma.

The presence of one or more of these antineuronal antibodies detected by both immunoblot (IB) and immunofluorescence (IFA) supports a clinical diagnosis of PND and should lead to a focused search for the underlying neoplasm. A positive IB result but negative IFA result is of questionable clinical significance. Thus, strong clinical correlation is recommended.
 

Compliance Category

Laboratory Developed Test (LDT)

Performing Department

ARUP REF LAB - SEND OUTS

Performing Department Laboratory Location

ARUP REF LAB - SEND OUTS

Methodology

Qualitative Immunoblot / Semi-Quantitative Indirect Fluorescent Antibody (IFA)

CPT

84182 x4; if reflexed add 86255; 86256

Neuronal Nuclear Antibodies (Hu, Ri, Yo, and Tr/DNER) IgG by Immunoblot. If low positive, positive, or high positive, then the neuronal nuclear (ANNA) antibody and Purkinje cell (PCCA) antibody IgG are screened by IFA. If the IFA screen is positive at 1:10, then a specific titer (ANNA or PCCA) will be added. Additional charges apply.

CDM Code

3008418206

Epic Test ID

123010794

LOINC

3002918 Purkinje Cell Ab (Yo) IgG, IB, Ser 12853-8
3002919 Purkinje Cell Ab (TR/DNER) IgG, IB, Ser 63440-2
3002920 Neuronal Nuclear Ab (Ri) IgG, IB, Serum 33008-4
3002921 Neuronal Nuclear Ab (Hu) IgG, IB, Serum 41769-1

Reviewed Date

Added 5/1/2025