Usefulness of antibody index assessment in cerebrospinal fluid from patients negative for total-IgG oligoclonal bands

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Abstract

Background: Testing for cerebrospinal fluid (CSF)-restricted oligoclonal bands (OCB) by isoelectric focusing is used to detect intrathecally produced total IgG. By contrast, antibody indices (AI) are assessed to test for intrathecally produced antigen-specific IgG. A number of previous cases reports have suggested that AI testing might be more sensitive than OCB testing in detecting intrathecal IgG synthesis.Findings: Here we report on 21 patients with positive AI for either herpes simplex virus, varicella zoster virus, cytomegalovirus, measles virus, rubella virus, or Borrelia burgdorferi in the absence of total-IgG OCB and, accordingly, in the presence of a normal total-IgG CSF/serum ratio.Conclusion: Our findings indicate that AI testing should not generally be omitted in OCB-negative patients and provide a rationale for systematic and prospective studies on the comparative sensitivity and specificity of AI and total-IgG OCB testing in infectious and other diseases of the CNS. © 2012 Jarius et al.; licensee BioMed Central Ltd.

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Jarius, S., Eichhorn, P., Wildemann, B., & Wick, M. (2012). Usefulness of antibody index assessment in cerebrospinal fluid from patients negative for total-IgG oligoclonal bands. Fluids and Barriers of the CNS, 9(1). https://doi.org/10.1186/2045-8118-9-14

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