Anti-Hu-antibodies

Anti-Hu antibody was the first recognized autoantibody marker for small cell lung cancer (Graus et al., 1985). In an earlier study of 162 consecutive patients with anti-Hu antibodies, malignant disease was present in 88% of patients, and small cell lung cancer was present in 93%.

Although patients with anti-Hu antibodies present with a wide range of paraneoplastic neurologic manifestations, including cerebellar ataxia, limbic encephalitis, myelopathy, Lambert-Eaton syndrome, and myopathy, peripheral neuropathy is the most common manifestation, occurring in 60% to 80% of patients.

Hu-Abs detects a 35-40 kD family of proteins located in the nucleus and to a lesser extent in the cytoplasm of central and peripheral nervous system neurons. The estimated specificity and sensitivity of anti-Hu antibodies for sensory neuropathy of paraneoplastic etiology are 99% and 82%, respectively. In addition to the conventional sensory ataxic form of paraneoplastic sensory neuronopathy, the painful form of paraneoplastic sensory neuropathy may also be associated with anti-Hu antibody positivity. In addition, approximately 30% of patients with anti-Hu antibodies have some features of dysautonomia, the most common being chronic gastrointestinal pseudodysfunction.

1. Pranzatelli MR et al (2017) Neuroimmunology of OMS and ANNA-1/anti-Hu paraneoplastic syndromes in a child with neuroblastoma. Neurol Neuroimmunol Neuroinflamm 5:e433.