Laboratory Test Information Guide

Details for Paraneoplastic Antibody Panel, Serum/CSF

Test Name: Paraneoplastic Antibody Panel, Serum/CSF
Alternate Name(s): Anti-Hu (ANNA-1)
Anti-Yo (PCA-1)
Anti-Ri (ANNA-2)
Anti-CV2 (CRMP5)
Anti-Tr (DNER)
Laboratory: Clinical Immunology
Specimen Type: Adult:
5 mL Gold top Vacutainer tube or 6 mL Red top Vacutainer tube

EDTA, heparin or citrate plasma are also acceptable

0-2 years: 0.5 mL Red Microtainer
2-10 years: 2 mL Red top tube

CSF samples will also be accepted. Suggest CSF be submitted with serum for testing.
Collection Information: Volume required for testing is 1.0 mL
Minimum volume is 0.5 mL
Test Schedule: Batched analysis
Turnaround time from when specimen
is received in testing laboratory:
7 days
Reference Range: Negative
Effective Date: 2021-06-22
Revised Date: 2021-09-10
Critical Value:  
Interpretive Comments: Paraneoplastic syndromes are a group of rare disorders; some of which are caused by autoimmune reactions against antigens co-expressed by cancer cells and neurons. Below are the most frequent cancers associated with paraneoplastic syndromes and autoantibodies.

Antibodies againstAssociated Neurological DisordersFrequently Associated Tumors
Hu (ANNA-1)Paraneoplastic encephalomyelitisSmall cell lung cancer, neuroblastoma
Yo (PCA-1)Paraneoplastic cerebellar degenerationOvarian cancer, breast cancer, uterine carcinoma
Ri (ANNA-2)Paraneoplastic opsoclonus mycoclonus ataxiaNeuroblastoma, Breast cancer
Ma2/TaRhombencephalitis, paraneoplastic limbic encephalitis, brain stem encephalopathyGerminal carcinoma of the testis (seminoma)
AmphiphysinStiff-person syndrome, Myasthenic syndromeBreast cancer, small cell lung cancer
CV2 (CRMP5)Limbic encephalitisSmall cell lung cancer, thymoma
RecoverinRetinopathySmall cell lung cancer
SOX1Lambert-Eaton myasthenic syndromeSmall cell lung cancer
TitinMyasthenia gravisThymoma
Anti-Zic4Paraneoplastic cerebellar degenerationSmall cell lung cancer
Tr (DNER)Paraneoplastic cerebellar degenerationHodgkin's lymphoma
GAD65Stiff-person syndromeSmall cell lung cancer
Special Processing:  
Comments: This test is available only to external clients.
Method of Analysis: Immunoblot.

Positive for anti Hu, Yo, Ri, amphiphysin, CV2, Ma2, SOX-1, Zic4 and Tr (DNER) by immunoblot will be reflexed to tissue indirect immunofluorescence (TIIF) assay (reported based on immunoblot).

Positive for anti-GAD65 by immunoblot will be reflexed to GAD65 ELISA.

Anti-titin and anti-recoverin antibodies will be determined by immunoblot only.
Critical Information Required: Each sample must be submitted with a clinical questionnaire completed by the treating physician, which should take no more than 10-15 minutes to complete.

Clinical Questionnaire
Dr. Adrian Budhram will review the provided clinical information for every positive neural antibody result, and contact the ordering physician to promptly review the result and aid in clinical-serological correlation.
Storage & Shipment: Sample can be stored for up to 14 days at 4oC. For longer storage, store at -20oC.
Send samples together with a completely filled out questionnaire.
System Codes: 
PNAS for serum/PNACSF for CSF
Referred To:  

Questions? Comments? Contact Laura Gopaul