Ordering Recommendation

Useful for the evaluation of classic paraneoplastic neurologic syndrome.

Mnemonic
NRNL IB S
Methodology

Qualitative Immunoblot

Performed

Mon, Thu, Sat

Reported

1-4 days

New York DOH Approval Status
This test is New York DOH 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

Reference Interval
Test Number
Components
Reference Interval
  Neuronal Nuclear Ab (Yo) IgG, IB, Serum Negative
  Neuronal Nuclear Ab (TR/DNER) IgG, IB 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's lymphoma.

The presence of one or more of these antineuronal antibodies supports a clinical diagnosis of PND and should lead to a focused search for the underlying neoplasm

Compliance Category

Laboratory Developed Test (LDT)

Note
Hotline History
N/A
CPT Codes

84182 x4

Components
Component Test Code* Component Chart Name LOINC
3002918 Neuronal Nuclear Ab (Yo) IgG, IB, Serum 12853-8
3002919 Neuronal Nuclear Ab (TR/DNER) IgG, IB 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
  • DNER
  • Hu, Ri, Yo, and Tr/DNER Ab
  • Hu; Ri; Yo; Tr/DNER
  • Neuronal Ab Immunoblot
  • Neuronal Nuclear Ab IgG
  • Paraneoplastic
  • PCA-3
  • Tr
Neuronal Nuclear Antibodies (Hu, Ri, Yo, Tr/DNER) IgG by Immunoblot, Serum