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HelpTest Code AN1TS Antineuronal Nuclear Antibody-Type 1 (ANNA-1) Titer, Serum (Non-Orderable)
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
PCDES / Pediatric Autoimmune Encephalopathy/CNS Disorder Evaluation, Serum
Useful For
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
PCDES / Pediatric Autoimmune Encephalopathy/CNS Disorder Evaluation, Serum
Serological evaluation of patients who present with a subacute neurological disorder of undetermined etiology, especially those with risk factors for primary lung carcinoma
Directing a focused search for cancer
Investigating neurological symptoms that appear during, or after, cancer therapy, and are not explainable my metastasis
Reporting an end titer result from serum specimens
Testing Algorithm
If the indirect immunofluorescence pattern suggests antineuronal nuclear antibody type 1 (ANNA-1), then this test will be performed at an additional charge.
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
PCDES / Pediatric Autoimmune Encephalopathy/CNS Disorder Evaluation, Serum
Indirect Immunofluorescence Assay (IFA)
Reporting Name
ANNA-1 Titer, SSpecimen Type
SerumSpecimen Minimum Volume
Serum: 0.6 mL
Specimen Stability Information
| Specimen Type | Temperature | Time |
|---|---|---|
| Serum | Refrigerated (preferred) | 28 days |
| Frozen | 28 days | |
| Ambient | 72 hours |
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
PCDES / Pediatric Autoimmune Encephalopathy/CNS Disorder Evaluation, Serum
<1:240
Interpretation
Antineuronal nuclear antibody type 1 (ANNA-1) is highly specific for the presence of a paraneoplastic neurological syndrome and/or cancer. It has been detected in patients with small-cell lung carcinoma (SCLC) without evidence of neurological autoimmunity. It is detected before SCLC is diagnosed in half of the cases and its presence suggests that the patient's neurological presentation is paraneoplastic. It is specific for the HuD or ELAVL4 antigen.
Clinical Reference
1. Lucchinetti CF, Kimmel DW, Lennon VA. Paraneoplastic and oncologic profile of patients seropositive for type 1 antineuronal nuclear autoantibodies. Neurology. 1998;50(3):652-657
2. Vernino S, Eggenberger ER, Rogers LR, Lennon VA. Paraneoplastic neurological autoimmunity associated with ANNA-1 autoantibody and thymoma. Neurology. 2002;59(6):929-932
3. Pranzatelli MR, McGee NR. Neuroimmunology of OMS and ANNA-1/anti-Hu paraneoplastic syndromes in a child with neuroblastoma. Neurol Neuroimmunol Neuroinflamm. 2017;5(2):e433. doi:10.1212/NXI.0000000000000433
4. Horta ES, Lennon VA, Lachance DH, et al. Neural autoantibody clusters aid diagnosis of cancer. Clin Cancer Res. 2014;20(14):3862-3869
5. Zekeridou A. Paraneoplastic neurologic disorders. Continuum (Minneap Minn). 2024;30(4):1021-1051. doi:10.1212/CON.0000000000001449
6. Paramasivan NK, Masoud M, Karsten C, et al. Phenotypic and oncological insights in ANNA1 autoimmunity: Age stratification and biomarker analysis. Ann Clin Transl Neurol. 2025;12(2):280-290. doi:10.1002/acn3.52254
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
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| AN1TS | ANNA-1 Titer, S | 94342-3 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| 43431 | ANNA-1 Titer, S | 94342-3 |