Test Category: Immunology
Investigation Name:Paraneoplastic Antibodies Immunoblot
Alias or Abbreviation:Paraneoplastic blot, Neuronal
Intro:
Indication:Paraneoplastic neurological antibodies are associated with paraneoplastic neurological syndrome and systemic malignancies.
Further information:
Antibodies tested:
Yo (PCA-1), Hu (ANNA1), Ri (ANNA2), GAD65, CV2/CRMP5, Amphiphysin, SOX1, Tr (DNER), Zic4, Recoverin, Ma2/Ta, Titin.
Paraneoplastic disorders are characterised by the presence of neuronal autoantibodies in patient serum.
Tumours that have been known to initiate paraneoplastic disorders include small cell lung carcinoma (SCLC), thymoma, neuroblastoma, and breast, ovarian, and testicular cancers.
The following autoantibodies can be found in paraneoplastic syndromes:
Anti-Hu: Type I anti-neuronal nuclear antibody (ANNA-1) is associated with SCLC, resulting in paraneoplastic encephalomyelitis.
Anti-Ri: Type II anti-neuronal nuclear antibody (ANNA-2) is associated with neuroblastoma (children) and fallopian or breast cancer (adults), resulting in paraneoplastic opsoclonus myoclonus ataxia (POMA)
Anti-Yo: Anti-Purkinje cell antibody is associated with gynaecological tumours and breast cancer, resulting in PCD.
Anti-Tr: Anti-purkinje cell antibody is associated with Hodgkin's disease, resulting in cerebellar degeneration.
Anti-Ta (Ma2): Anti-neuronal antibody is associated with testicular tumours, and can lead to limbic or brain stem encephalomyelitis.
Amphiphysin: Associated with tumours of the breast or SCLC leading to opsoclonus, ataxia.
RMP/CV2: Associated with various tumours, including thymoma, leading to variety of clinical presentations.
Zic4: Autoantibodies to Zic4 are associated with paraneoplastic cerebellar degeneration and the underlying tumour is often a small cell lung cancer.
SOX1: In up to 50 percent of patients with Lambert-Eaton myasthenic syndrome (LEMS) - if cancer is detected, almost always a small cell lung cancer (SCLC). In 43 percent of patients with LEMS and SCLC the detectable antibodies are directed to SOX1.
Titin: Autoantibodies to Titin can be seen in patients with Myasthenia Gravis and can be associated with the presence of thymoma.
Recoverin: Autoantibodies to Recoverin have been associated with cancer-associated retinopathy (CAR), a paraneoplastic blinding disease.
Pathology Laboratory:Immunology laboratory
Requestable Seperately?No
Minimum Sample Volume:0.25mL
Expected Turnaround Time:Frequency: Daily Target: 10 days
Test Code:PARB
Sample Type:
Serum Gel Tube (Gold top)/ PlasmaComplex Reference Range:Positive/ Negative
Collection Conditions / Other Information:1st class post or Transport
Referred to Another Laboratory?No
Storage Requirements:Ambient temperature
NPEX / PDF Reporting Available:Yes
EQA Scheme:Yes
Further information:Reflexed if paraneoplastic antibody screen is positive
Lead Contact Details:rwh-tr.bcpsimmunologyclinicalqueries@nhs.net
Email Address For Chasing Results:rwh-tr.ImmunologyLab@nhs.net
Methodology:Immunoblot
UKAS Reference Number:9580 (recommended)
Site Sample Tested:Immunology, New Cross Hospital, Wolverhampton
Contact Number:01902 695 279 or Ext 85279
