Neuronal Antibodies

Also known as: Paraneoplastic Antibody

Paraneoplastic disorders are characterized by the presence of neuronal autoantibodies in patient serum. The detection of these autoantibodies is useful for the clinician, as it suggests the presence of an underlying tumour. Tumours that have been known to initiate paraneoplastic disorders include small cell lung carcinoma (SCLC), thymoma, neuroblastoma, and breast, ovarian, and testicular cancers. The following autoantibodies are found in paraneoplastic syndromes:

• Anti-Hu
  Type I anti-neuronal nuclear antibody (ANNA-1) is associated with SCLC, resulting in paraneoplastic encephalomyelitis.
• Anti-Ri
  Type II anti-neuronal nuclear antibody (ANNA-2) is associated with neuroblastoma (children) and fallopian or breast cancer (adults), resulting in paraneoplastic opsoclonus myoclonus ataxia (POMA).
• Anti-Yo
  Anti-Purkinje cell antibody is associated with gynaecological tumours and breast cancer, resulting in PCD
• Anti-Tr
  Anti-purkinje cell antibody is associated with Hodgkin's disease, resulting in cerebellar degeneration.
• Anti-Ma (Ma1)
  Anti-neuronal antibody is not associated with any specific tumour, and can lead to limbic or brain stem encephalomyelitis.
• Anti-Ta (Ma2)
  Anti-neuronal antibody is associated with testicular tumours, and can lead to limbic or brain stem encephalomyelitis.
• Amphiphysin
  Associated with tumours of the breast or SCLC leading to opsoclonus, ataxia
• RMP/CV2
  Associated with various tumours, including thymoma, leading to variety of clinical presentations.
• Zic4: Autoantibodies to Zic4 are associated with paraneoplastic cerebellar degeneration and the underlying tumor is often a small cell lung cancer.
• SOX1: In up to 50 % of patients with Lambert-Eaton myasthenic syndrome (LEMS) - if cancer is detected, almost always a small cell lung cancer (SCLC). In 43 % of patients with LEMS and SCLC the detectable antibodies are directed to SOX1.

Specimen requirements

Serum 1ml; plasma is acceptable but CSF not required although can be tested.

Cost

• UK NHS - 25 UKP
• International and Private - 30 UKP

Laboratory turnaround time

14 days

Laboratory method

Immunofluorescence with all Positives confirmed by Immunoblot

Reference range/units

Not applicable

Associated tests

Not applicable

Shipping and storage

UK and Ireland

Ambient temperature and first class post. Hays DX users please enquire via email below.

International

Ambient temperature if courier will deliver within 72 hours otherwise consider refrigerated transport. Freezing is not a requirement.

Ensure delivery Monday to Friday 07:00 - 17:30.

Further information and contact details

For further information, email immunology.office@nhs.net