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Test Name:
Neuronal Nuclear IgG Antibody, by IFA, with Titer and Immunoblot if Indicated, Serum

• SBMF No:
  44064
• Performance Lab Name:
  ARUP Laboratories
• Test Mnemonic:
  ANNAR
• ABN:
  Required – Not FDA-Approved
• CPT Code:
  86255
  If indicated, add 83516; 86256
• LOINC Code:
  11088-2
• Ref Lab Test No:
  0050904
• Test Includes:
  Neuronal Nuclear Antibody (ANNA) IgG Screen, by IFA
  Neuronal Nuclear Antibody (ANNA) IgG Titer, by IFA (If Indicated)
  Neuronal Nuclear Antibodies (ANNA) IgG, Immunoblot (If Indicated)
• Also Known As:
  ANNA
  Hu
  Ri
• Also See:
  44512 Neuronal Nuclear IgG Antibodies (Hu and Ri), by Immunoblot
• Spec Type:
  Serum
• Spec Container:
  Gold top (SST) or red top (serum) tube
• Pref Vol:
  1.0 mL
• Min Vol:
  0.15 mL
• Fasting:
  No
• Spec Collect:
  Routine venipuncture
• Spec Process:
  Clot 30 minutes
  Promptly centrifuge 15 minutes
  Immediately transfer serum to separate plastic tube and freeze
• Spec Store Transport:
  Frozen
• Spec Stability:
  After separation from cells
  24 hours room temperature (20-30°C)
  2 weeks refrigerated (2-8°C)
  1 year frozen (-20°C) – Do not use frost-free units that undergo repeated freeze/thaw cycles
• Spec Reject:
  Plasma sample
  Contaminated, heat-inactivated, hemolyzed, or lipemic sample
• Spec Remarks:
  Separate serum from cells ASAP or within 2 hours of collection
• Methodology:
  Semi-Quantitative Indirect Fluorescent Antibody (IFA)
  Qualitative Immunoblot
• Clinical Significance:
  Refer to:
  
• Reference Range:
  

  Neuronal Nuclear Antibody (ANNA) IgG Screen, by IFA
  < 1:10

  Neuronal Nuclear Antibody (ANNA) Reflex IFA Titer, IgG
  < 1:10 No antibody detected

  Neuronal Nuclear Antibody IgG, Immunoblot Anti-Hu
  Negative

  Neuronal Nuclear Antibody IgG, Immunoblot Anti-Ri
  Negative

  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 specimen will be titered to endpoint and confirmed (Hu or Ri) by immunoblot.

  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. Additional charges apply.

• Additional Test Info:
  This test was developed and its performance characteristics determined by ARUP Laboratories. The U.S. Food and Drug Administration has not approved or cleared this test; however, FDA clearance or approval is not currently required for clinical use. The results are not intended to be used as the sole means for clinical diagnosis or patient management decisions.
• Day Run:
  Wed
• Time Reported:
  2-10 days
• Test Type:
  IMMUNOLOGY