ARUP's Laboratory Test Directory

0050904: Neuronal Nuclear Antibody (ANNA) IgG by IFA with Reflex to Titer & Immunoblot, Serum

Test Mnemonic: ANNAR
Methodology: Indirect Fluorescent Antibody/Immunoblot

Performed: Wed

Reported: 1-9 days

Specimen Required:  
Collect: One 4 mL SST.

Transport: 1 mL serum, frozen. (Min: 0.5 mL)  Submit specimen in an ARUP Standard Transport Tube.

Pediatric Collection/Transport: 0.15 mL serum, frozen.

Remarks: Separate serum from cells ASAP.

Unacceptable Conditions: Plasma.  Severely lipemic, contaminated, heat-inactivated, or hemolyzed specimens.

Stability: After separation from cells: Ambient: 24 hours; Refrigerated: 5 days; Frozen: 1 year

Reference Interval:
 
Test Number Components Reference Interval
 Neuronal Nuclear Antibody (ANNA) IgG Screen, by IFA < 1:10
0050892Neuronal Nuclear Antibody (ANNA) Reflex IFA Titer, IgG < 1:10 No antibody detected
0051088Neuronal Nuclear Antibodies (ANNA) IgG, Immunoblot, Serum  
 
Test Number Components Reference Interval
 Neuronal Nuclear Antibody IgG, Immunoblot Anti-Hu Refer to test 0051147
 Neuronal Nuclear Antibody IgG, Immunoblot Anti-Ri Refer to test 0051148

Interpretive Data:
ANNA-1 (anti-Hu) and ANNA-2 (anti-Ri) are screened by immunofluorescence and confirmed by immunoblot detection of antibody reactive with a 35-40 kDa (ANNA-1) or a 55 kDa (ANNA-2) neuronal protein.  ANNA-1 is present in patients with paraneoplastic syndromes (paraneoplastic sensory neuropathy or paraneoplastic encephalomyelitis) most commonly associated with small-cell lung carcinoma (SCLC).  ANNA-2 is present in patients with midbrain encephalitis, cerebellar ataxia, eye movement disorders (usually opsoclonus), and occasionally myelopathy.  Neoplasms most often associated with ANNA-2 are breast carcinoma and SCLC.  ANNA-1 and ANNA-2 may be detectable before the associated neoplasm is detectable.

ANNA antibodies are screened by IFA.  If the IFA screen shows reactivity at 1:10, the sample will be titered to endpoint and confirmed (Hu or Ri) by immunoblot.

Please refer to Statement D in the Compliance Statements section in the front of the Laboratory Test Directory.



Note:
ANNA antibodies are screened by IFA. If the IFA screen is 1:10, then a titer and immunoblot (Hu and Ri) will be added.

CPT Code(s):
86255 ANNA; if reflexed, add 86256 ANNA titer and 83516 Immunoblot

 

 

 
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