Cerebrospinal fluid oligoclonal bands in the diagnosis of multiple sclerosis: Isoelectric focusing with IgG immunoblotting compared with high-resolution agarose gel electrophoresis and cerebrospinal fluid IgG index

• Published in: American journal of clinical pathology 2003-11, Vol.120 (5), p.672-675
• Main Authors: FORTINI, Alexandre S, SANDERS, Elizabeth L, WEINSHENKER, Brian G, KATZMANN, Jerry A
• Format: Article
• Language: English
• Subjects: Biological and medical sciences; Electrophoresis, Agar Gel; False Positive Reactions; Humans; Immunoblotting; Immunoglobulin G - cerebrospinal fluid; Isoelectric Focusing; Medical sciences; Multiple Sclerosis - cerebrospinal fluid; Multiple Sclerosis - diagnosis; Multiple Sclerosis - immunology; Multiple sclerosis and variants. Guillain barré syndrome and other inflammatory polyneuropathies. Leukoencephalitis; Neurology; Sensitivity and Specificity
• ISSN: 0002-9173; 1943-7722
• DOI: 10.1309/Y5VFF2UAW0RK5W63

Multiple sclerosis (MS) is an inflammatory demyelinating disease of the central nervous system. We compared the diagnostic performance of isoelectric focusing (IEF) combined with IgG immunoblotting to high-resolution agarose gel electrophoresis for the detection of intrathecal synthesis of IgG due to the MS disease process. In 20 patients with definite MS, IEF and high-resolution agarose gel electrophoresis had sensitivities of 90% and 60%, respectively. In the 51 patients with no evidence of MS, the methods had specificities of 94% and 96%, respectively. With a prevalence of 15% in this test population, IEF and high-resolution agarose gel electrophoresis had positive predictive values of 73% and 73% and negative predictive values of 98% and 93%, respectively. The IEF method improves the sensitivity and the negative predictive value of the oligoclonal-banding assay, the IEF gels are easier to interpret, and the IEF assay requires a smaller cerebrospinal fluid volume.