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Paraneoplastic neurological autoimmunity associated with ANNA-1 autoantibody and thymoma

From the Departments of Neurology (Drs. Vernino and Lennon), Immunology (Dr. Lennon), and Laboratory Medicine and Pathology (Dr. Lennon), Mayo Clinic, Rochester, MN; Departments of Neurology and Ophthalmology (Dr. Eggenberger), Michigan State University, East Lansing; and Departments of Neurology and Neurosurgery (Dr. Rogers), Henry Ford Hospital, Detroit, MI.

Address correspondence and reprint requests to Dr. Steven Vernino or Dr. Vanda A. Lennon, Neuroimmunology Laboratory, Guggenheim 828, Mayo Clinic, 200 First Street SW, Rochester, MN 55905; e-mail: lennon.vanda{at}mayo.edu

Neurologic autoimmunity frequently occurs with thymoma, particularly myasthenia gravis and skeletal muscle–specific autoantibodies. Type 1 antineuronal nuclear antibody (ANNA-1/"anti-Hu"), which is recognized as an immunoglobulin G marker of small-cell lung carcinoma, has not been reported with thymoma. The authors identified four patients (three under age 40) with ANNA-1 and a paraneoplastic neurologic complication of thymoma. Retrospective testing of stored serum from 172 patients with thymoma revealed ANNA-1 in 3%. This report extends the oncologic implications of ANNA-1 seropositivity.

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