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Unit Code 8017:
Oligoclonal Banding, Serum and Spinal Fluid

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Useful For

Diagnosis of multiple sclerosis; especially useful in patients with

equivocal clinical presentation and radiological findings

Clinical Information

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 cerebro-

spinal 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%).

Reference Values

CSF Olig Bands Interpretation: <4 bands

Interpretation

A finding of 4 or more CSF-specific bands (ie, bands that are present

in CSF but are absent in serum) is consistent with MS.

 

The presence of OCB is unrelated to disease activity.

Cautions

These tests are not specific for MS.

Clinical Reference

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

Key