Diagnostic value of kappa free light chains in patients with one isolated band in isoelectric focusing
| Autor: | Matthias Grothe, Christine Holbe, Matthias Nauck, Malte Johannes Hannich, Marie Süße, Alexander Dressel, Fritz Feistner |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Male 0301 basic medicine medicine.medical_specialty Multiple Sclerosis Oligoclonal band Clinical Biochemistry Immunoglobulin light chain Intrathecal Biochemistry Gastroenterology Immunoglobulin kappa-Chains 03 medical and health sciences 0302 clinical medicine Cerebrospinal fluid hemic and lymphatic diseases Internal medicine Humans Medicine In patient Aged business.industry Isoelectric focusing Biochemistry (medical) General Medicine Gold standard (test) Middle Aged 030104 developmental biology 030220 oncology & carcinogenesis Female Isoelectric Focusing business Kappa |
| Zdroj: | Clinica Chimica Acta. 507:205-209 |
| ISSN: | 0009-8981 |
| DOI: | 10.1016/j.cca.2020.04.029 |
| Popis: | Objectives Oligoclonal band (OCB) determination in cerebrospinal fluid (CSF) is the gold standard to detect intrathecal inflammation. However, there is uncertainty about the significance of one isolated band in CSF. Free light chains kappa (FLC-k) are gaining interest as a complementary method to detect intrathecal inflammation. The aim of this study was to investigate the performance of an additive measurement of FLC-k in patients with one isolated band in CSF. Materials & Methods FLC-k were analyzed using the nephelometric Siemens FLC-k kit in paired samples of CSF and sera (n = 56) in patients with one isolated band in isoelectric focusing. According to medical diagnosis, samples were subdivided in inflammatory neurological disease, non-inflammatory neurological disease controls and symptomatic controls. Intrathecal fraction of FLC-k was plotted in a FLC-k quotient diagram. OCB interpretation was done blinded by three experienced raters. Results Of 6695 OCB analyses, 91 (1.4%) had one isolated band in CSF. After exclusion of patient samples due to unclear OCB pattern after reevaluation and sample availability, 56 patient samples were included in the study. All patients with an inflammatory origin of disease (n = 13) had FLC-k values above the upper discrimination line (Qlim) in the FLC-k quotient diagram, resulting in a sensitivity of 100% with a positive predictive value of 52% and a negative predictive value of 100%. Fourteen patients (36%) with a non-inflammatory origin of disease (n = 39) had FLC-k values above Qlim. Conclusions In patients with one isolated band in CSF, a lack of intrathecal fraction of FLC-k strongly favors a non-inflammatory orgin of disease. Implementation of FLC-k measurement can help the clinician in the diagnostic process of neurological diseases. |
| Databáze: | OpenAIRE |
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