Kappa free light chains in cerebrospinal fluid to identify patients with oligoclonal bands
| Autor: | Matthias Nauck, Marie Süße, Maik Pietzner, Astrid Petersmann, Alexander Dressel, Stephanie Zylla, Malte Johannes Hannich |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Adult
Male 0301 basic medicine Multiple Sclerosis Immunoglobulin light chain Sensitivity and Specificity Cohort Studies Immunoglobulin kappa-Chains 03 medical and health sciences 0302 clinical medicine Nephelometry and Turbidimetry Predictive Value of Tests Humans Immunologic Factors Medicine Prospective Studies Prospective cohort study Aged business.industry Oligoclonal Bands Reproducibility of Results Gold standard (test) Middle Aged 030104 developmental biology ROC Curve Neurology Immunoglobulin G Predictive value of tests Cohort Female Neurology (clinical) business Nuclear medicine Nephelometry 030217 neurology & neurosurgery Kappa Cohort study |
| Zdroj: | European Journal of Neurology. 25:1134-1139 |
| ISSN: | 1351-5101 |
| Popis: | Background and purpose The gold standard for detection of intrathecal immunoglobulin synthesis is the measurement of oligoclonal bands (OCB). In the diagnosis of multiple sclerosis, the kappa free light chains (KFLC) index has a similar sensitivity and specificity as OCB. This study investigated whether determination of the KFLC index could be used to predict the presence of OCB. Methods The KFLC index was determined prospectively from 295 paired serum and cerebrospinal fluid samples. KFLC were determined by nephelometry using the N Latex FLC kappa kit (Siemens Healthcare Diagnostics Products GmbH) on the BN Prospec analyzer (Siemens Healthcare Diagnostics Products GmbH) (cohort I). A cut-off value was determined using receiver operating characteristic analysis in relation to OCB positivity. These results were validated prospectively in 96 samples (cohort II) as well as retrospectively in samples of 46 patients known to be OCB positive (cohort III). We also compared the agreement of two commercially available nephelometric KFLC assays. Results In cohort I, a KFLC index of 3.61 yielded 100% sensitivity and 88% specificity. Prospective validation of this cut-off value in cohort II showed 92% sensitivity and 96% specificity. In cohort III, a sensitivity of 93% was achieved. Comparison of Siemens and Binding Site (Birmingham, UK) assays revealed good agreement (r2 = 0.86). Conclusions The KFLC index with a cut-off value of 3.61 had high diagnostic accuracy to predict immunoglobulin G synthesis via OCB analysis. Determination of the KFLC index provided a quantitative parameter that could be used as an initial diagnostic step in inflammatory central nervous system disorders before measuring OCB. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Plný text