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Neuronal Nuclear Antibodies

Hu, Ri, Yo, Tr/DNER, Anti Hu, Anti RI, Anti Yo, Neuronal Ab Immunoblot, Neuronal Nuclear Ab IgG

Test Codes

EPIC: LAB1231558, Beaker: XNNAB, ARUP: 3002917

Department

Send Outs

Specimen Collection Criteria

Collect (preferred specimen): One Gold-top SST tube.

Physician Office/Draw Specimen Preparation

Let specimen clot 30-60 minutes then centrifuge to separate serum from cells within 2 hours of collection. Transfer serum to a plastic transport tube and refrigerate (2-8°C or 36-46°F).

Preparation for Courier Transport

Transport: 1 mL serum; refrigerated (2-8°C or 36-46°F). (Minimum: 0.3 mL)

Rejection Criteria

• Specimens not collected and processed as indicated. 
• Plasma
• Grossly hemolyzed specimen
• Grossly lipemic specimen

In-Lab Processing

Let specimen clot 30-60 minutes then centrifuge to separate serum from cells within 2 hours of collection. Transfer serum to a plastic transport tube and refrigerate (2-8°C or 36-46°F).

Storage

Specimen Stability for Testing:

Room Temperature (20-26°C or 68-78.8°F): 48 hours
Refrigerated (2-8°C or 36-46°F): 14 days
Frozen (-20°C/-4°F or below): 30 days

Specimen Storage in Department Prior to Disposal:

Specimen retention time is determined by the policy of the reference laboratory. Contact the Send Outs Laboratory with any questions.

Laboratory

Sent to ARUP Laboratory in Salt Lake City, UT.

Performed

Monday, Thursday, Saturday
Results available in 1-4 days.

Reference Range

Negative.

Test Methodology

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

Interpretation

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's lymphoma.

The presence of one or more of these antineuronal antibodies supports a clinical diagnosis of PND and should lead to a focused search for the underlying neoplasm.

Clinical Utility

Neuronal nuclear autoantibodies (NNA) are useful in the diagnosis of paraneoplastic autoimmune neuropathies, encephalomyeloradiculopathies, related neurologic disorders, and intestinal pseudo-obstruction/dysmotility associated with small cell lung carcinoma.

CPT Codes

84182 x 4: if reflexed add 86255, 86256.
LOINC:  41769-1

Contacts

Last Updated

4/14/2025