DIAGNOSTIC TEST 220

Hu (ANNA-1) Antibodies (IgG)

Diagnostic test for antibodies against Hu. For suspicion of paraneoplastic syndrome.

swedac

Accredited. View list of accredited tests [.pdf]

Indication

Suspicion of paraneoplastic syndrome

Sample material

Serum

  • Minim. volume: 0,5 mL

CSF

  • Minim. volume: 2,0 mL

Transport

  • Within Sweden: room temperature
  • International: cold

Method

Immunoblot and Indirect immunofluorescence (IIF)

According to Updated Diagnostic Criteria for Paraneoplastic Neurologic Syndromes, anti-neuronal antibodies should be detected by at least two independent methods to be reliable. At Wieslab IIF and immunoblot are used.

Reference interval

Serum

Immunoblot: <6 negative

Indirect Immunofluorescence: <1:10 negative

CSF

Immunoblot: negative

Indirect immunofluorescence: negative

Result

Serum

Immunoblot: results are reported as negative, borderline, or positive with an intensity value.

Indirect immunofluorescence (IIF): results are reported as negative or positive. Positive results will be titrated.

CSF

Immunoblot: results are reported as negative, borderline, or positive.

Indirect immunofluorescence (IIF): results are reported as negative or positive.

Interpretation

Antibodies against Hu are also called ANNA-1 (anti-neuron-specific cell nuclear antibodies) and occur in paraneoplastic subacute sensory neuronopathy and/or paraneoplastic encephalomyelitis. The antibody occurrence is strongly associated with small cell lung cancer (SCLC) but can also be seen in other tumor types (e.g. breast cancer, Hodgkin's lymphoma, melanoma, ovarian cancer, testicular cancer, thymoma). Neurological symptoms can precede cancer diagnosis by up to 5 years.

Antibodies against Hu are graded as High-risk antibodies with a frequency of 85% of underlying cancer and a positive result gives 3 points PNS score, according to Updated Diagnostic Criteria for Paraneoplastic Neurologic Syndromes.

References

  • Rosenfeld MR, Dalmau J. Neurol Clin. 2018. Paraneoplastic Neurologic Syndromes. PMID: 30072076
  • Graus F et al. Neurol Neuroimmunol Neuroinflamm. 2021. Updated Diagnostic Criteria for Paraneoplastic Neurologic Syndromes. PMID: 34006622
  • Guasp M, Dalmau J. Neurology. 2023. Searching for Neuronal Antibodies in Psychiatric Diseases: Uncertain Findings and Implications. PMID: 37353340
  • Kerstens J et al. Neurol Neuroimmunol Neuroinflamm. 2024. Autoimmune Encephalitis and Paraneoplastic Neurologic Syndromes: A Nationwide Study on Epidemiology and Antibody Testing Performance. PMID: 39467237
  • Paramasivan NK, et al. Ann Clin Transl Neurol. 2025. Phenotypic and oncological insights in ANNA1 autoimmunity: Age stratification and biomarker analysis. PMID: 39556523

Included in these panels

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How to order

This test is available worldwide for hospitals, clinics, and physicians.

  1. Print and complete the request form

    Download the request form. Clearly state the name and phone number of the referring hospital, clinic, or physician. If you are a new customer, please also include a completed customer information form.

  2. Prepare your samples

    Serum: At least 0.5 mL serum (plain serum tubes without additives).
    CSF: At least 2 mL CSF (polypropylene tubes).

  3. Send samples and request form

    Within Sweden
    Samples can be sent at room temperature to:
    Envelopes and smaller boxes:
    Wieslab AB, Box 50117, 20211 Malmö, Sweden

    Larger boxes and frozen samples:
    Wieslab AB, Lundavägen 151, 21224 Malmö, Sweden

    International
    Send samples cold to:
    Wieslab AB, Lundavägen 151, 21224 Malmö, Sweden

Last updated: 2026-09-21