Neurology

Anti–Ri (ANNA-2) Antibodies

Test details

Paraneoplastic neurological syndromes (PNS) are immune-mediated neurological disorders that occur in association with cancer and are often supported by the presence of specific neuronal autoantibodies.

 

Neuronal autoantibodies are classified as high-, intermediate-, or low-risk for paraneoplastic aetiology. High-risk antibodies show a >70% association with cancer, typically recognise intracellular antigens and are not directly pathogenic. The associated tumour type depends on patient demographics and on the specific neuronal autoantibody identified.

 

Two naming conventions are used: one based on the index patient’s initials (e.g., Hu), and another that describes the immunohistochemical staining pattern (e.g., ANNA = anti-neuronal nuclear antibodies).

 

Anti-Ri (ANNA-2) antibodies are markers of autoimmune neuronal disease such as cerebellar/brainstem syndromes and opsoclonus–myoclonus syndrome. Their association with small-cell lung carcinoma (SCLC), non-small-cell lung cancer (NSCLC) and breast cancer is >70%.

 

For high-risk PNS, autoantibody testing should be performed using at least two independent methods.

Sample type

Serum, EDTA plasma, heparin plasma, citrate plasma, CSF

Method

Immunoblot

Preparation

Fasting for at least 8-12 hours before sampling

Storage conditions

Refer to the Health Service Charter to check storage conditions

Shipping

+2/+8°C

References

Graus F, Vogrig A, Muñiz-Castrillo S, Antoine JG, Desestret V, Dubey D, Giometto B, Irani SR, Joubert B, Leypoldt F, McKeon A, Prüss H, Psimaras D, Thomas L, Titulaer MJ, Vedeler CA, Verschuuren JJ, Dalmau J, Honnorat J. Updated Diagnostic Criteria for Paraneoplastic Neurologic Syndromes. Neurol Neuroimmunol Neuroinflamm. 2021 May 18;8(4):e1014. doi: 10.1212/NXI.0000000000001014. PMID: 34006622; PMCID: PMC8237398.

Simard C, Vogrig A, Joubert B, Muñiz-Castrillo S, Picard G, Rogemond V, Ducray F, Berzero G, Psimaras D, Antoine JC, Desestret V, Honnorat J. Clinical spectrum and diagnostic pitfalls of neurologic syndromes with Ri antibodies. Neurol Neuroimmunol Neuroinflamm. 2020 Mar 13;7(3):e699. doi: 10.1212/NXI.0000000000000699. PMID: 32170042; PMCID: PMC7136048.

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