Guidelines on the detection of paraneoplastic anti-neuronal-specific antibodies

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Abstract
For the clinician, it is often difficult to arrive at a reliable diagnosis of the neurologic syndrome and to detect the underlying tumor. Neurologic signs and symptoms, although often stereotypic, are not specific. In two-thirds of cases the underlying tumor is not discovered until after the first neurologic symptoms. [4] Furthermore, the neoplasm may be small and difficult to detect. [5-7] PNS are frequently associated with serum autoantibodies reactive with neuronal antigens that are also present in the underlying tumor. These antibodies include (1) the anti-Yo antibody, also called "type 1 anti-Purkinje cell antibody" (PCA-1), "APCA-1," or "type I antibody"; (2) the anti-Hu antibody, also called "type 1 anti-neuronal nuclear antibody" (ANNA-1) or "type IIa antibody"; and (3) the anti-Ri antibody, also called "type 2 anti-neuronal nuclear antibody" (ANNA-2) or "type IIb antibody" Table 1. A clinical diagnosis of PNS is supported by the finding of these specific anti-neuronal antibodies. The detection of these antibodies should also lead to a focused search for specific underlying neoplasms. [8-12]