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Test Code AN3TC Antineuronal Nuclear Antibody Type 3 (ANNA-3) Titer, Spinal Fluid


Ordering Guidance


Serum is preferred. Spinal fluid testing is particularly useful if interfering antibodies are present in the serum.



Specimen Required


Only orderable as a reflex. For more information see:

-DMC2 / Dementia, Autoimmune/Paraneoplastic Evaluation, Spinal Fluid

-ENC2 / Encephalopathy, Autoimmune/Paraneoplastic Evaluation, Spinal Fluid

-EPC2 / Epilepsy, Autoimmune/Paraneoplastic Evaluation, Spinal Fluid

-MDC2 / Movement Disorder, Autoimmune/Paraneoplastic Evaluation, Spinal Fluid

-MAC1 / Myelopathy, Autoimmune/Paraneoplastic Evaluation, Spinal Fluid

 

Container/Tube: Sterile vial

Specimen Volume: 4 mL


Useful For

Evaluating patients who present with a subacute neurological disorder of undetermined etiology and have risk factors for primary lung carcinoma

 

Reporting an end titer result from cerebrospinal fluid specimens

Testing Algorithm

If the indirect immunofluorescence (IFA) pattern suggests antineuronal nuclear antibody type 3 (ANNA-3), then this test will be performed at an additional charge.

Method Name

Only orderable as a reflex. For more information see:

-DMC2 / Dementia, Autoimmune/Paraneoplastic Evaluation, Spinal Fluid

-ENC2 / Encephalopathy, Autoimmune/Paraneoplastic Evaluation, Spinal Fluid

-EPC2 / Epilepsy, Autoimmune/Paraneoplastic Evaluation, Spinal Fluid

-MDC2 / Movement Disorder, Autoimmune/Paraneoplastic Evaluation, Spinal Fluid

-MAC1 / Myelopathy, Autoimmune/Paraneoplastic Evaluation, Spinal Fluid

 

Indirect Immunofluorescence Assay (IFA)

Reporting Name

ANNA-3 Titer, CSF

Specimen Type

CSF

Specimen Minimum Volume

2 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
CSF Refrigerated (preferred) 28 days
  Frozen  28 days
  Ambient  72 hours

Reference Values

Only orderable as a reflex. For more information see:

-DMC2 / Dementia, Autoimmune/Paraneoplastic Evaluation, Spinal Fluid

-ENC2 / Encephalopathy, Autoimmune/Paraneoplastic Evaluation, Spinal Fluid

-EPC2 / Epilepsy, Autoimmune/Paraneoplastic Evaluation, Spinal Fluid

-MDC2 / Movement Disorder, Autoimmune/Paraneoplastic Evaluation, Spinal Fluid

-MAC1 / Myelopathy, Autoimmune/Paraneoplastic Evaluation, Spinal Fluid

 

<1:2

Neuron-restricted patterns of IgG staining that do not fulfill criteria for antineuronal nuclear antibody type 3 may be reported as "unclassified antineuronal IgG. "Complex patterns that include nonneuronal elements may be reported as "uninterpretable."

Interpretation

A positive result confirms that a patient's subacute neurological disorder has an autoimmune basis and predicts with 90% certainty that the patient has an aerodigestive carcinoma, usually a small-cell lung carcinoma (SCLC) that is new or recurrent and confined to the chest.

 

Fifteen percent of patients who are eventually proven to have small-cell carcinoma have an unrelated often more obvious cancer, either coexisting or in the past.

 

Antineuronal nuclear autoantibody type 3 (ANNA-3) has not yet been encountered in healthy subjects (n=100) or patients with lung carcinoma without a neurological accompaniment (n=100) or with other cancers (n=300).

Clinical Reference

1. Graus F, Cordon-Cardo C, Posner JB: Neuronal antinuclear antibody in sensory neuropathy from lung cancer. Neurology. 1985 April;35(4):538-543

2. Lucchinetti CF, Kimmel DW, Lennon VA: Paraneoplastic and oncologic profile of patients seropositive for type 1 antineuronal nuclear autoantibodies. Neurology. 1998 Mar;50(3):652-657

3. Vernino S, Eggenberger ER, Rogers LR, Lennon VA: Paraneoplastic neurological autoimmunity associated with ANNA-1 autoantibody and thymoma. Neurology. 2002 Sep 24;59(6):929-932

4. Pittock SJ, Lucchinetti CF, Lennon VA: Anti-neuronal nuclear autoantibody-type 2: paraneoplastic accompaniments. Ann Neurol. 2003 May;53(5):580-587

5. Chan KH, Vernino S, Lennon VA: ANNA-3 anti-neuronal nuclear antibody: marker of lung cancer-related autoimmunity. Ann Neurol. 2001 Sep;50(3):301-311

6. Pittock SJ, Kryzer TJ, Lennon VA: Paraneoplastic antibodies coexist and predict cancer, not neurological syndrome. Ann Neurol. 2004 Nov;56(5):715-719

7. Horta ES, Lennon VA, Lachance DH, et al: Neural autoantibody clusters aid diagnosis of cancer. Clin Cancer Res. 2014 Jul 15;20(14):3862-3869

Day(s) Performed

Monday through Sunday

Report Available

6 to 8 days

Performing 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
AN3TC ANNA-3 Titer, CSF 94358-9

 

Result ID Test Result Name Result LOINC Value
43442 ANNA-3 Titer, CSF 94358-9