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A B C D E F G H I J K L M N O P Q

Test Identifier Information

 
Registration CodeCSFO
Method

Quantitation of CSF IgG, CSF Albumin, Serum IgG and Serum Albumin is performed by nephelometry (Siemens BNII).  The values obtained are used to calculate the CSF Index and IgG Synthesis rate.

Oligoclonal Band detection is performed using the Sebia Hydragel CSF Focusing assay.  This assay uses the prinicple of agarose gel ioselectric focusing followed by immunofixation with peroxidase labelled anti-IgG antisera.  The patient's serum and CSF samples are analysed in parallel in order to compare the IgG distribution.

 


 

Diagnostic Use / Indications
The diagnosis of multiple sclerosis (MS) is dependent on clinical, radiological, and laboratory findings. The detection of increased intrathecal immunoglobulin (Ig) synthesis is the basis for current diagnostic laboratory tests for MS. These tests include the CSF index, IgG synthesis rate and CSF oligoclonal band detection. Abnormal CSF indexes and oligoclonal banding patterns have been reported in 70% to 80% of MS patients. At least 1 of these tests has been reported to be positive in 90% of MS patients when both tests are performed.  
Newer methodologies for oligoclonal band detection have been reported to be more sensitive, with sensitivities of 90% to 95% in CSF from MS patients. 
Increased intrathecal Ig synthesis may occur in other inflammatory CSF diseases and, therefore, this assay is not specific for MS (specificity = 95%).
 
External Price$209.12(Exclusive of GST)
  

Specimen Collection

 
Specimen Collection Protocols

Both CSF and Serum are required.  Serum should preferrably be collected at the time of the spinal tap, however serum collected 3 days before or after the collection of CSF is also acceptable.  Plasma is also acceptable although a serum is preferable.

Patient Specimen0.5 mL CSF and 0.5 mL Serum(Red)
Paediatric Specimen0.5 mL CSF and 250 ÁL Serum(Red)
Sample Delivery to LabAmbient
  

Instructions for Referral to CHLabs

 
Aliquot InstructionsMinimum 0.5 mL CSF and 0.5 mL serum.
Aliquot Transport to CHLRefridgerated (preferred) or ambient
  

CHLabs Laboratory

 
DepartmentBiochemistry - Protein Laboratory
Contact Details Email Email
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Contact Phone Number(03)3640334 | x80334
Test AvailabilityMonday to Friday, 8.00 am - 5.00 pm.
Turnaround Time1 -3 days
Reference Interval
ParameterValue
CSF IgG<0.08 g/L
CSF Albumin<0.40 g/L
Serum IgG7.0-14.0 g/L
Serum Albumin32-48 g/L
CSF Index<0.6
IgG Synthesis<4.0 mg/day

A comment will also be made on the presence or absence of oligoclonal banding. 

Interpretation

The presence of multiple IgG bands in the CSF of a patient, and the absence of any corresponding bands in the patient's serum is indicative of oligoclonal banding arising from intrathecal synthesis. 

An IgG Synthesis rate of >4.0 mg/day is also strongly supportive of oligoclonal banding, but can also be elevated by the presence of blood in the CSF, or other causes of inflammation.

Additional Information

Refer to Biochemistry - Protein Laboratory ext 80334

Delphic Number Test Number3210

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