Journal
AMERICAN JOURNAL OF CLINICAL PATHOLOGY
Volume 120, Issue 5, Pages 672-675Publisher
OXFORD UNIV PRESS INC
DOI: 10.1309/Y5VFF2UAW0RK5W63
Keywords
multiple sclerosis; cerebrospinal fluid; oligoclonal bands; isoelectric focusing; high-resolution agarose gel electrophoresis; cerebrospinal fluid IgG index
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Multiple sclerosis (MS) is an inflaminatory 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.
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