Kappa index for multiple sclerosis diagnosis: an accurate biomarker of intrathecal synthesis.

Autor: Vecchio D; Neurology Unit, Department of Translational Medicine, Maggiore Della Carità University Hospital, University of Piemonte Orientale, Corso Mazzini 18, 28100, Novara, Italy. domizia.vecchio@gmail.com., Puricelli C; Clinical Biochemistry Laboratory, Department of Health Sciences, Maggiore Della Carità University Hospital, University of Piemonte Orientale, Novara, Italy., Virgilio E; Neurology Unit, Department of Translational Medicine, Maggiore Della Carità University Hospital, University of Piemonte Orientale, Corso Mazzini 18, 28100, Novara, Italy., Passarelli F; Clinical Biochemistry Laboratory, Department of Health Sciences, Maggiore Della Carità University Hospital, University of Piemonte Orientale, Novara, Italy., Guida S; Clinical Biochemistry Laboratory, Department of Health Sciences, Maggiore Della Carità University Hospital, University of Piemonte Orientale, Novara, Italy., Naldi P; Neurology Unit, Department of Translational Medicine, Maggiore Della Carità University Hospital, University of Piemonte Orientale, Corso Mazzini 18, 28100, Novara, Italy., Crespi I; Clinical Biochemistry Laboratory, Department of Health Sciences, Maggiore Della Carità University Hospital, University of Piemonte Orientale, Novara, Italy., Dianzani U; Clinical Biochemistry Laboratory, Department of Health Sciences, Maggiore Della Carità University Hospital, University of Piemonte Orientale, Novara, Italy., Comi C; Neurology Unit, Department of Translational Medicine, Maggiore Della Carità University Hospital, University of Piemonte Orientale, Corso Mazzini 18, 28100, Novara, Italy.
Jazyk: angličtina
Zdroj: Journal of neurology [J Neurol] 2024 Dec 12; Vol. 272 (1), pp. 30. Date of Electronic Publication: 2024 Dec 12.
DOI: 10.1007/s00415-024-12826-y
Abstrakt: Background: Cerebrospinal fluid (CSF) kappa-free light chains (KFLC) are becoming a diagnostic biomarker for multiple sclerosis (MS).
Objectives: We aimed to compare the diagnostic performance of intrathecal synthesis biomarkers to that of oligoclonal bands (OB) in diagnosing MS, radiological and clinical isolated syndromes (RIS-CIS) on a large cohort of patients collected over 10 years.
Methods: We collected 1124 patients (58% females) in 10 years who underwent CSF analysis for intrathecal synthesis in the diagnostic work-up, and they were classified according to their diagnosis as 417 MS, 287 with other neurological inflammatory disorders (including 76 RIS-CIS), and 420 non-inflammatory diseases (excluding lymphoproliferative and infective diagnosis).
Results: MS patients significantly differ from all other groups (including if considering the RIS-CIS cohort) for CSF KFLC, KFLC intrathecal fraction (IF), Kappa index, and OB. Evaluating the diagnostic performance, the Kappa index cut-off was 6.4 for diagnosing MS and 5.7 for predicting OB. A diagnostic algorithm could avoid IEF if the Kappa index is higher than 20.
Conclusions: The KFLC index confirmed its accuracy for MS diagnosis in this large Italian cohort, adding information also in the RIS-CIS population.
Competing Interests: Declarations. Conflicts of interest: None for all authors for this work. Ethics approval: Local Ethical Committee approvals (Comitato Etico Interaziendale AOU “Maggiore della Carità” di Novara, ASL BI, ASL NO, ASL VCO): CE 060/2022 and 260/2022). Consent to participate/consent for publication: written consent obtained from all participants.
(© 2024. Springer-Verlag GmbH Germany, part of Springer Nature.)
Databáze: MEDLINE
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