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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.
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
-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 |
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."
Interpretation
This autoantibody is rarely found in adult patients without asbestos exposure, or a long history of tobacco use or passive exposure. Sixty-six percent of seropositive patients are female; small-cell lung carcinoma (SCLC) has been confirmed in 83% of those with adequate follow-up. In 15% with confirmed SCLC, an unrelated and more obvious primary malignancy coexists with SCLC.
Antineuronal nuclear antibody type 1 is found before SCLC is diagnosed in 55% of cases.
Positron emission tomography (PET) scanning, magnetic resonance imaging of the chest, and transesophageal ultrasound sometimes reveal malignant adenopathy when computerized tomography is negative. An extrapulmonary primary small cell carcinoma should be considered, especially in nonsmoking patients (eg, skin, larynx, tongue, breast, cervix, ovary, prostate, endocrine, or pancreas).
Autopsy sometimes reveals SCLC in patients who lack evidence of tumor in life.
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
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 |