Utility of anti-Hu antibodies in the diagnosis of paraneoplastic sensory neuropathy

Anti-Hu antibodies (Hu-Abs) were positive in 40 patients with paraneoplasti c sensory neuropathy (PSN) and in 1 patient with idiopathic sensory neuropa thy in a series of 126 patients who presented with clinical features sugges tive of PSN. The specificity of Hu-Abs was 99% and the sensitivity was 82%. Nine (18%) PSN patients were Hu-Ab-negative, and their sera did not harbor other specific anti-neuronal or anti-ganglioside antibodies. Small cell lu ng carcinoma (SCLC) was the leading neoplasm in the Hu-Ab-positive (79%) an d Hu-Ab-negative (44%) groups. This study confirms the value of Hu-Abs for the diagnosis of PSN and SCLC and also emphasizes that in patients with pos sible PSN, the absence of Hu-Abs does not exclude cancer, particularly in t hose patients with risk factors for SCLC.