Neuronal Nuclear Antibodies (Hu, Ri, Yo, Tr/DNER) IgG by Immunoblot, Serum
Test Mnemonic
HURIYO
CPT Codes
- 84182 - QTY (4)
LOINC ®
35278-1
Includes
- Purkinje Cell Ab (Yo) IgG, IB, Ser
- Purkinje Cell Ab (TR/DNER) IgG, IB, Ser
- Neuronal nuclear Ab Hu, IgG
- Neuronal nuclear Ab Ri, IgG
Performing Laboratory
ARUP
Specimen Requirements
| Volume | Type | Container | Collect Temperature | Transport Temperature | Special Instructions |
|---|---|---|---|---|---|
| 1 mL | Serum | SST (Gold) | Refrigerated | Separate serum from cells ASAP or within 2 hours of collection. |
Minimum Specimen Requirements
| Volume | Type | Container | Collect Temperature | Transport Temperature | Special Instructions |
|---|---|---|---|---|---|
| 0.3 mL |
Stability
| Environmental Condition | Description |
|---|---|
| Refrigerated | After separation from cells: 2 weeks |
| Ambient | After separation from cells: 48 hours |
| Frozen | After separation from cells: 1 month |
Days Performed
Mon, Thu, Sat
Turnaround Time
2 - 5 days
Methodology
| Name | Description |
|---|---|
| Immunoblot (IB), Qualitative | |
| Semi-Quantitative Indirect Fluorescent Antibody |
Special Info
This test may be a reflex from Motor and Sensory Neuropathy Evaluation with Reflex to Titer and Neuronal Immunoblot (SENMOT) or Sensory Neuropathy Antibody Panel with Reflex to Titer and Neuronal Immunoblot (SENNRO). Reflex algorithm: Each reflex test performed incurs additional charge. If positive (low/high), 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. Grossly hemolyzed, heat-inactivated, contaminated, or lipemic specimens will be rejected.
Clinical Info
This assay 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 fallopian tube and breast cancer in adults and neuroblastoma in children. Anti-Yo (anti-Purkinje cell cytoplasmic antibody) is associated with ovarian and breast cancer. Anti-Tr(DNER) is associated with Hodgkin lymphoma. 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.
Reflex Tests
The following additional test(s) may be ordered depending on results: