CSF-Oligoclonal Banding, CSF + Serum

Diagnostic Use

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 CSF index, IgG synthesis rate and CSF oligoclonal band detection. Abnormal CSF indexes and oligoclonal banding 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 tests are performed.
Newer methodologies for oligoclonal band 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%).

Department

Protein Lab

Delphic Registration Code

CSFO

Synonyms

CSF electrophoresis
CSF IgG synthesis rate
CSF index
OB
Oligoclonal Banding

Turnaround Time

5 days

Test Code

3210

Specimen Type

• Serum
• CSF

Specimen Requirements

Tube/Container Type:

Preferred

• Pottle
• Serum (Red Cap)

Acceptable

• SST II (Gold Cap)
• Lithium Heparin - Non-gel (Green Cap)
• Lithium Heparin - Gel (Green Cap)

Preferred Sample Volume (ml)

0.5

Minimum Sample Volume (ml)

0.25

No of Samples Required

2

Interferences

Blood contaminated CSF collects.

Additional Specimen Information

A paired CSF AND Serum sample are always required. Serum should preferrably be collected at the time of the spinal tap, however serum collected 3 days before or after the collection of CSF is also acceptable. In the absence of a suitable serum sample, plasma is acceptable.

Aliquot Instructions

Minimum Volume (ml)

0.25

Transport to Lab

Chilled (2 - 8 degrees Celsius)

Additional Referral/Aliquot Information

Preferred volumes: 0.5 mL CSF and 0.5 mL serum.

Interpretation

When the oligoclonal band assay detects 2 or more unique IgG bands in the CSF, with no corresponding bands in the serum, the result is positive.
An IgG Synthesis rate of > 4.0 mg/day is also strongly supportive of oligoclonal banding, but can also be elevated by the presence of blood in the CSF, or other causes of inflammation.

Reference Intervals

Parameter	Value
CSF IgG	<0.08 g/L
CSF Albumin	<0.40 g/L
Serum IgG	7.0-14.0 g/L
Serum Albumin	32-48 g/L
CSF Index	<0.6
IgG Synthesis	<4.0 mg/day

A comment will also be made on the presence or absence of oligoclonal banding.

Test Method

Quantitation of CSF IgG, CSF Albumin, Serum IgG and Serum Albumin is performed by immunoassay on Siemens BNII.
These values are used to calculate the CSF Index and IgG Synthesis rate.

Oligoclonal Band detection is performed by agarose gel isoelectric focusing followed by immunofixation with peroxidase labelled anti-IgG antisera. Assay is performed on a Sebia Hydrasys.

Non-Funded Test Cost

$227.37 (Exclusive of GST)

Billing Code

3210

Additional Costing Information

Refer to Biochemistry - Protein Laboratory ext 80334

Contact Information

Enquiry Form