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Interpretive Handbook

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Test 8017 :
Oligoclonal Banding, Serum and Spinal Fluid

Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test

The diagnosis of multiple sclerosis (MS) is dependent on clinical, radiological, and laboratory findings. The detection of increased intrathecal immunoglobulin (Ig) synthesis is the basis for current diagnostic laboratory tests for MS. These tests include the cerebrospinal fluid (CSF) IgG index and CSF oligoclonal band (OCB) detection. Abnormal CSF IgG indexes and OCB patterns have been reported in 70% to 80% of MS patients. At least 1 of these tests has been reported to be positive in 90% of MS patients when both test are performed.

 

Newer methodologies for OCB detection have been reported to be more sensitive, with sensitivities of 90% to 95% in CSF from MS patients.

 

Increased intrathecal Ig synthesis may occur in other inflammatory CSF diseases and, therefore, this assay is not specific for MS (specificity = 95%).

Useful For Suggests clinical disorders or settings where the test may be helpful

Diagnosis of multiple sclerosis; especially useful in patients with equivocal clinical presentation and radiological findings

Interpretation Provides information to assist in interpretation of the test results

A finding of 4 or more cerebrospinal fluid (CSF)-specific bands (ie, bands that are present in CSF but are absent in serum) is consistent with multiple sclerosis.

 

The presence of oligoclonal band is unrelated to disease activity.

Cautions Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances

These tests are not specific for multiple sclerosis.

Reference Values Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.

CSF Olig Bands Interpretation: <4 bands

Clinical References Provides recommendations for further in-depth reading of a clinical nature

1. Andersson M, Alvarez-Cermeno J, Bernardi G, et al: Cerebrospinal fluid in the diagnosis of multiple sclerosis: a consensus report. J Neurol Neurosurg Psychiatry 1994;57:897-902

2. Fortini AS, Sanders EL, Weinshenker BG, Katzmann JA: Cerebrospinal fluid oligoclonal bands in the diagnosis of multiple sclerosis, isoelectric focusing with the IgG immunoblotting compared with high resolution agarose gel electrophoresis and cerebrospinal fluid IgG index. Am J Clin Pathol 2003:120:672-675


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