DIAGNOSTIC TEST 220

Hu (ANNA-1) Antibodies (IgG)

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

swedac

Accredited. View certificate [.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/ 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: <5 negative
  • Indirect Immunofluorescence: <1:10 negative

Likvor

  • 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 prevalence is strongly associated with small-cell lung cancer 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 yield 3 points PNS score, according to Updated Diagnostic Criteria for Paraneoplastic Neurologic Syndromes.

References

  • Lancaster E et al. Neurology. 2011. Encephalitis and antibodies to synaptic and neuronal cell surface proteins. PMID: 21747075
  • Zuliani L et al. J Neurol Neurosurg Psychiatry. 2012. Central nervous system neuronal surface antibody associated syndromes: review and guidelines for recognition. PMID: 22448032
  • Rosenfeld MR, Dalmau J. Neurol Clin. 2018. Paraneoplastic Neurologic Syndromes. PMID: 30072076
  • Balint B et al. Brain. 2018. Movement disorders with neuronal antibodies: syndromic approach, genetic parallels and pathophysiology. PMID: 29053777
  • Graus F et al. Neurol Neuroimmunol Neuroinflamm. 2021. Updated Diagnostic Criteria for Paraneoplastic Neurologic Syndromes. PMID: 34006622
  • Scheper T et al, EUROLINE_WB allows reliable differentiation of autoantibodies against neural antigens in patients with paraneoplastic neurological syndrome, In: “From proteinomic to Molecular Epidemiology: Relevance of Autoantibodies”, 6th Dresden Symposium on Autoantibodies. 2002, Vol 3, 562-563
  • Garza M, Piquet AL. Front Neurol. 2021. Update in Autoimmune Movement Disorders: Newly Described Antigen Targets in Autoimmune and Paraneoplastic Cerebellar Ataxia. PMID: 34489848

Included in these panels

Need pricing information?

Get a quote

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.

  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

Read our sampling instructions for more information

Last updated: 2025-08-18