Cerebrospinal fluid in the diagnosis of multiple sclerosis: a consensus report.

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Serval ID
serval:BIB_739F242E559F
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Cerebrospinal fluid in the diagnosis of multiple sclerosis: a consensus report.
Journal
Journal of Neurology, Neurosurgery, and Psychiatry
Author(s)
Andersson M., Alvarez-Cermeño J., Bernardi G., Cogato I., Fredman P., Frederiksen J., Fredrikson S., Gallo P., Grimaldi L.M., Grønning M.
ISSN
0022-3050 (Print)
ISSN-L
0022-3050
Publication state
Published
Issued date
1994
Volume
57
Number
8
Pages
897-902
Language
english
Notes
Publication types: Comparative Study ; Consensus Development Conference ; Journal Article ; ReviewPublication Status: ppublish
Abstract
The Committee of the European Concerted Action for Multiple Sclerosis (Charcot Foundation) organised five workshops to discuss CSF analytical standards in the diagnosis of multiple sclerosis. This consensus report from 12 European countries summarises the results of those workshops. It is hoped that neurologists will confer with their colleagues in clinical chemistry to arrange the best possible local practice. The most sensitive method for the detection of oligoclonal immunoglobulin bands is isoelectric focusing. The same amounts of IgG in parallel CSF and serum samples are used and oligoclonal bands are revealed with IgG specific antibody staining. All laboratories performing isoelectric focusing should check their technique at least annually using "blind" standards for the five different CSF and serum patterns. Quantitative measurements of IgG production in the CNS are less sensitive than isoelectric focusing. The preferred method for detection of blood-CSF barrier dysfunction is the albumin quotient. The CSF albumin or total protein concentrations are less satisfactory. These results must be interpreted with reference to the age of the patient and the local method of determination. Cells should be counted. The normal value is no more than 4 cells/microliters. Among evolving optional tests, measurement of the combined local synthesis of antibodies against measles, rubella, and/or varicella zoster could represent a significant advance if it offers higher specificity (not sensitivity) for identifying chronic rather than acute inflammation. Other tests that may have useful correlations with clinical indices include those for oligoclonal free light chains, IgM, IgA, or myelin basic protein concentrations.
Keywords
Acute Disease, Adolescent, Adult, Age Factors, Albumins/cerebrospinal fluid, Cell Count, Cerebrospinal Fluid/chemistry, Cerebrospinal Fluid/cytology, Cerebrospinal Fluid Proteins/analysis, Chronic Disease, Humans, Immunoglobulin G/cerebrospinal fluid, Isoelectric Focusing/methods, Middle Aged, Multiple Sclerosis/blood, Multiple Sclerosis/cerebrospinal fluid, Quality Control, Sensitivity and Specificity, Specimen Handling/methods
Pubmed
Web of science
Create date
10/02/2010 10:56
Last modification date
20/08/2019 14:31
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