3002917
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Neuronal Nuclear Antibodies (Hu, Ri, Yo, Tr/DNER) IgG by Immunoblot, Serum

NRNL IB S
Example Reports
Negative
Positive

Ordering Recommendation

Useful for the evaluation of classic paraneoplastic neurologic syndrome.

New York DOH Approval Status

This test is New York state approved.

Specimen Required

Patient Preparation
Collect

Serum separator tube

Specimen Preparation

Separate serum from cells ASAP or within 2 hours of collection. Transfer 1 mL serum to an ARUP standard transport tube. (Min: 0.30 mL)

Storage/Transport Temperature

Refrigerated

Unacceptable Conditions

Plasma. Contaminated, heat-inactivated, grossly hemolyzed, or lipemic specimens

Remarks
Stability

After separation from cells: Ambient: 48 hours; Refrigerated: 2 weeks; Frozen: 1 month

Methodology

Qualitative Immunoblot / Semi-Quantitative Indirect Fluorescent Antibody (IFA)

Performed

Mon, Thu, Sat

Reported

1-4 days

Reference Interval

Test Number
 Components
 Reference Interval
  Purkinje Cell Ab (Yo) IgG, IB, Ser Negative
  Purkinje Cell Ab (TR/DNER) IgG, IB, Ser Negative
  Neuronal Nuclear Ab (Ri) IgG, IB, Serum Negative
  Neuronal Nuclear Ab (Hu) IgG, IB, Serum Negative

Interpretive Data

This test detects IgG antineuronal antibodies to Hu, Ri, Yo and Tr (DNER) antigens.

Antineuronal antibodies serve as markers that aid in discriminating between a true paraneoplastic neurological disorder (PND) and other inflammatory disorders of the nervous system. Anti-Hu (antineuronal nuclear antibody, type I) is associated with small-cell lung cancer. Anti-Ri (antineuronal nuclear antibody, type II) is associated with neuroblastoma in children and with fallopian tube and breast cancer in adults. Anti-Yo (anti-Purkinje cell cytoplasmic antibody) is associated with ovarian and breast cancer. Anti-Tr(DNER) is associated with Hodgkin lymphoma.

The presence of one or more of these antineuronal antibodies detected by both immunoblot (IB) and immunofluorescence (IFA) supports a clinical diagnosis of PND and should lead to a focused search for the underlying neoplasm. A positive IB result but negative IFA result is of questionable clinical significance. Thus, strong clinical correlation is recommended.

Compliance Category

Laboratory Developed Test (LDT)

Note

Neuronal Nuclear Antibodies (Hu, Ri, Yo, and Tr/DNER) IgG by Immunoblot. If low positive, positive, or high positive, then the neuronal nuclear (ANNA) antibody and Purkinje cell (PCCA) antibody IgG are screened by IFA. If the IFA screen is positive at 1:10, then a specific titer (ANNA or PCCA) will be added. Additional charges apply.

Hotline History

View Hotline History

 

Hotline History

Date of Change
Test Name Change
Methodology
Performance/Reported Schedule
Specimen Requirements
Reference Interval
Interpretive Data
Note
CPT Code
Component Change
Other Interface Change
New Test
Inactive
04/21/2025
X
X
X
X
X
X
N/A

CPT Codes

84182 x4; if reflexed add 86255; 86256

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Components

Component Test Code* Component Chart Name LOINC
3002918 Purkinje Cell Ab (Yo) IgG, IB, Ser 12853-8
3002919 Purkinje Cell Ab (TR/DNER) IgG, IB, Ser 63440-2
3002920 Neuronal Nuclear Ab (Ri) IgG, IB, Serum 33008-4
3002921 Neuronal Nuclear Ab (Hu) IgG, IB, Serum 41769-1
* Component test codes cannot be used to order tests. The information provided here is not sufficient for interface builds; for a complete test mix, please click the sidebar link to access the Interface Map.

Aliases

  • Hu, Ri, Yo, and Tr/DNER Ab
  • Hu; Ri; Yo; Tr/DNER
  • Neuronal Ab Immunoblot
  • Neuronal Nuclear Ab IgG
  • Paraneoplastic
  • PCA-3
  • Tr
  • DNER
Neuronal Nuclear Antibodies (Hu, Ri, Yo, Tr/DNER) IgG by Immunoblot, Serum