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The authors of this retrospective study evaluated the clinical significance of a single cerebrospinal fluid immunoglobulin band for the diagnosis of inflammatory neurologic disorders. They identified 214 patients with a single immunoglobulin band. Among these patients, 17 were eventually diagnosed with multiple sclerosis, and 71 were diagnosed with another inflammatory neurologic disorder; this accounted for 41% of the patients with a single immunoglobulin band. Eventually, 37 patients (17%) were diagnosed with cancer.
These data are important for neurologists in interpreting a single CSF immunoglobulin band. Workup should be repeated as clinically indicated given that over 50% of these patients were eventually diagnosed with an inflammatory disorder.
– Kyle Binder, MD
This abstract is available on the publisher's site.
To demonstrate an inflammatory process in the central nervous system, the presence of at least two immunoglobulin (Ig) bands in the cerebrospinal fluid (CSF) is required. So far, the presence of a single abnormal Ig band is considered as negative.
The objective was to assess retrospectively the significance of a single CSF Ig band in clinical practice.
METHODS AND RESULTS
Out of 10,286 CSF analyses, we retained 214 results with single Ig. An inflammatory neurological disorder was diagnosed in 41% of patients.
Despite a modest sensitivity, the presence of a single CSF Ig band may be a biomarker of an inflammatory mechanism and, as such, may prompt the clinician to repeat the analysis when the clinical context remains suggestive.