Validation of CSF free light chain in diagnosis and prognosis of multiple sclerosis and clinically isolated syndrome: prospective cohort study in Buenos Aires
| Autor: | Edgardo Cristiano, Jimena Miguez, Francisco Sánchez, Carolina Azcona, Juan Ignacio Rojas, Liliana Patrucco, María Soledad Saez, María Victoria Lorenzón, Patricia Sorroche |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male medicine.medical_specialty CIENCIAS MÉDICAS Y DE LA SALUD Neurology PROGRESSION Medicina Clínica FREE LIGHT CHAINS DIAGNOSIS Sensitivity and Specificity Gastroenterology Immunoglobulin kappa-Chains 03 medical and health sciences 0302 clinical medicine Immunoglobulin lambda-Chains Internal medicine Statistical significance medicine Humans Prospective Studies 030212 general & internal medicine Medical diagnosis Prospective cohort study MULTIPLE SCLEROSIS Clinically isolated syndrome medicine.diagnostic_test business.industry Multiple sclerosis CLINICALLY ISOLATED SYNDROME Neurología Clínica Prognosis medicine.disease Immunoassay Female Neurology (clinical) business Biomarkers 030217 neurology & neurosurgery Kappa Demyelinating Diseases Follow-Up Studies |
| Zdroj: | Journal of Neurology. 266:112-118 |
| ISSN: | 1432-1459 0340-5354 |
| DOI: | 10.1007/s00415-018-9106-2 |
| Popis: | Background: The objective was to evaluate the precision of kappa and lambda free light chains (KFLC and LFLC) in CSF for the diagnosis of multiple sclerosis (MS) and prognosis of clinically isolated syndrome (CIS). Methods: CSF and serum samples from CIS, MS and other neurological non-MS disease were collected between 2015 and 2017. FLC concentrations were measured using immunoassay Freelite™. Results were correlated with the patients’ diagnoses and ROC curve analysis was used to determine accuracy. In CIS patients, analysis of FLC were compared in CIS converters vs. non-converter during follow-up. Results: In the MS group (n = 41), the optimal cut-off for KFLC determined was 7 mg/L, with a diagnostic sensitivity and specificity of 95% and 97%, respectively. The optimal cut-off for LFLC was 0.7 mg/L, with a diagnostic sensitivity and specificity of 71% and 81%, respectively. 36 CIS patients were included; mean follow-up time was 28 ± 9 months, and 22 (61.1%) patients converted to MS. The median concentration of CSF K and LFLCs at CIS diagnosis was slightly higher in CIS-converters compared to non-converters, but this did not reach statistical significance (KFLC: median 7 ± 5.3 mg/L vs. 5 ± 2.3 mg/L, p = 0.11; LFLC 0.7 ± 0.33 mg/L vs. 0.5 ± 0.23 mg/L p = 0.16). A strong correlation was observed between the concentration of K and L FLCs at diagnosis and the change in PBVC during follow-up (r = 0.72 and r = 0.65, respectively). Conclusion: KFLCs have a high sensitivity and specificity for the diagnosis of MS. FLC concentrations at CIS diagnosis were not significantly higher in CIS-converters. Fil: Sáez, María Soledad. Hospital Italiano; Argentina Fil: Rojas, Juan Ignacio. Hospital Italiano; Argentina Fil: Lorenzón, María Victoria. Hospital Italiano; Argentina Fil: Sánchez, Francisco. Hospital Italiano; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Centro de Estudios Farmacológicos y Botánicos. Universidad de Buenos Aires. Facultad de Medicina. Centro de Estudios Farmacológicos y Botánicos; Argentina Fil: Patrucco, Liliana. Hospital Italiano; Argentina Fil: Míguez, Jimena. Hospital Italiano; Argentina Fil: Azcona, Carolina. Hospital Italiano; Argentina Fil: Sorroche, Patricia. Hospital Italiano; Argentina Fil: Cristiano, Edgardo. Hospital Italiano; Argentina |
| Databáze: | OpenAIRE |
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