Neuronal Nuclear Antibodies (Hu, Ri, Yo, Tr/DNER) IgG by Immunoblot, Serum

Casandra

Casandra Test Code AR19438Version 1 (DRAFT)

Performing Lab

Lab ARUP LaboratoriesLab Test ID 3002917CPT Codes 84182, 86255, 86256

Neuronal Nuclear Antibodies (Hu, Ri, Yo, Tr/DNER) IgG by Immunoblot, Serum

Also known as: NRNL IB S

Clinical Use

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Use

This test evaluates the presence of antineuronal antibodies (IgG) specifically targeting Hu, Ri, Yo, and Tr/DNER antigens. The detection of these antibodies aids in distinguishing classic paraneoplastic neurological disorders from other inflammatory neurological conditions. Anti-Hu is typically associated with small-cell lung cancer, Anti-Ri with neuroblastoma and certain adult malignancies, Anti-Yo with ovarian and breast cancer, and Anti-Tr with Hodgkin lymphoma. The concurrent presence of these antibodies indicates a potential paraneoplastic neurologic syndrome and warrants a targeted search for associated neoplasms.

Special Instructions

This test was developed and its performance characteristics determined by ARUP Laboratories. It has not been cleared or approved by the US FDA but is intended for clinical purposes. The test includes both immunoblot (IB) and indirect fluorescent antibody (IFA) methodologies, and if low positive, positive, or high positive results are obtained, further IFA testing is conducted which may include reflex to titer assessment. Additional charges may apply for reflex tests.

Limitations

Antineuronal antibodies detected by IB but not corroborated by IFA are of uncertain significance and should be clinically correlated with other findings. The test has limitations in diagnosing cases where novel or less common antineuronal antibodies might be involved, and is not yet FDA-approved for clinical use. Interpretation should be cautious when IFA results contradict IB findings, necessitating clinical context to affirm conclusions.

Test Details

New York Approved