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HelpTest Code AN1TS Antineuronal Nuclear Antibody-Type 1 (ANNA-1) Titer, Serum
Specimen Required
Only orderable as a reflex. For more information see:
-AIAES / Axonal Neuropathy, Autoimmune/Paraneoplastic Evaluation, Serum
-DMS2 / Dementia, Autoimmune/Paraneoplastic Evaluation, Serum
-DYS2 / Dysautonomia, Autoimmune/Paraneoplastic Evaluation, Serum
-ENS2 / Encephalopathy, Autoimmune/Paraneoplastic Evaluation, Serum
-EPS2 / Epilepsy, Autoimmune/Paraneoplastic Evaluation, Serum
-GID2 / Gastrointestinal Dysmotility, Autoimmune/Paraneoplastic Evaluation, Serum
-MAS1 / Myelopathy, Autoimmune/Paraneoplastic Evaluation, Serum
-MDS2 / Movement Disorder, Autoimmune/Paraneoplastic Evaluation, Serum
-PAVAL / Paraneoplastic, Autoantibody Evaluation, Serum
-PCDES / Pediatric Autoimmune Encephalopathy/CNS Disorder Evaluation, Serum
Useful For
Diagnosis of paraneoplastic autoimmune neuropathies, encephalomyeloradiculopathies, related neurologic disorders, and intestinal pseudo-obstruction/dysmotility associated with small-cell lung carcinoma
Reporting an end titer result from serum specimens
This test alone should not be used as a general screening test for carcinoma of the lung.
Method Name
Only orderable as a reflex. For more information see:
-AIAES / Axonal Neuropathy, Autoimmune/Paraneoplastic Evaluation, Serum
-DMS2 / Dementia, Autoimmune/Paraneoplastic Evaluation, Serum
-DYS2 / Dysautonomia, Autoimmune/Paraneoplastic Evaluation, Serum
-ENS2 / Encephalopathy, Autoimmune/Paraneoplastic Evaluation, Serum
-EPS2 / Epilepsy, Autoimmune/Paraneoplastic Evaluation, Serum
-GID2 / Gastrointestinal Dysmotility, Autoimmune/Paraneoplastic Evaluation, Serum
-MAS1 / Myelopathy, Autoimmune/Paraneoplastic Evaluation, Serum
-MDS2 / Movement Disorder, Autoimmune/Paraneoplastic Evaluation, Serum
-PAVAL / Paraneoplastic, Autoantibody Evaluation, Serum
-PCDES / Pediatric Autoimmune Encephalopathy/CNS Disorder Evaluation, Serum
Indirect Immunofluorescence Assay (IFA)
Reporting Name
ANNA-1 Titer, SSpecimen Type
SerumSpecimen Minimum Volume
0.6 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Serum | Refrigerated (preferred) | 28 days | |
| Frozen | 28 days | ||
| Ambient | 72 hours |
Reject Due To
| Gross hemolysis | Reject |
| Gross lipemia | Reject |
| Gross icterus | Reject |
Clinical Information
A spectrum of paraneoplastic neurologic disorders (often multifocal) is found with antineuronal nuclear antibody type 1 (ANNA-1), also known as anti-Hu. Most frequent are neuropathies: mixed sensorimotor, pure sensory, predominantly autonomic, and least commonly, predominantly motor. Other manifestations include limbic encephalitis, subacute cerebellar degeneration, myelopathy, or radiculopathy.
Small-cell lung carcinoma (SCLC) is almost always present, although difficult to find. Extrapulmonary primary small-cell carcinoma thymoma or neuroblastoma is rarely encountered as the pertinent neoplasm. Whole body positron emission tomography (PET) scanning is justifiable in seropositive patients when no cancer is found.
ANNA-1 antibody is an extremely valuable marker of paraneoplastic intestinal dysmotilities associated with SCLC, ranging from gastroparesis to pseudo-obstruction. In this context it may be accompanied by muscle or ganglionic acetylcholine receptor (AChR) antibody, voltage-gated potassium channel antibody, striational antibody, glutamic acid decarboxylase 65 (GAD65) antibody, or thyroid or gastric parietal cell antibodies.
ANNA-1 antibody is uncommon in patients with SCLC without a neuropathy, including patients with Lambert-Eaton myasthenic syndrome or pure cerebellar ataxia.
ANNA-1 has been encountered in children with intestinal dysmotility, cerebellar ataxia, brain stem encephalitis, and myeloneuropathy with and without evident cancer (neuroblastoma).
Reference Values
Only orderable as a reflex. For more information see:
-AIAES / Axonal Neuropathy, Autoimmune/Paraneoplastic Evaluation, Serum
-DMS2 / Dementia, Autoimmune/Paraneoplastic Evaluation, Serum
-DYS2 / Dysautonomia, Autoimmune/Paraneoplastic Evaluation, Serum
-ENS2 / Encephalopathy, Autoimmune/Paraneoplastic Evaluation, Serum
-EPS2 / Epilepsy, Autoimmune/Paraneoplastic Evaluation, Serum
-GID2 / Gastrointestinal Dysmotility, Autoimmune/Paraneoplastic Evaluation, Serum
-MAS1 / Myelopathy, Autoimmune/Paraneoplastic Evaluation, Serum
-MDS2 / Movement Disorder, Autoimmune/Paraneoplastic Evaluation, Serum
-PAVAL / Paraneoplastic, Autoantibody Evaluation, Serum
-PCDES / Pediatric Autoimmune Encephalopathy/CNS Disorder Evaluation, Serum
<1:240
Neuron-restricted patterns of IgG staining that do not fulfill criteria for antineuronal nuclear antibody type 1 may be reported as "unclassified anti-neuronal IgG." Complex patterns that include nonneuronal elements may be reported as "uninterpretable."
Day(s) Performed
Monday through Sunday
Report Available
6 to 8 daysPerforming Laboratory
Mayo Clinic Laboratories in Rochester
Test Classification
This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.CPT Code Information
86256