sepharose and Meningitis

Seven different formulae and agarose isoelectrofocusing (AIF) using immunolabelling for IgG were compared for their ability to discriminate between intrathecally produced IgG and transudated IgG in cerebrospinal fluid. All reference limits were set to a specificity of 97.5% (reference group, n = 211). The probability of a positive test (p+) was evaluated for 112 patients with multiple sclerosis (MS), 42 with meningitis, 114 with noninflammatory diseases affecting the central nervous system (CNS), 23 with Guillain-Barré syndrome, and 56 with various diseases not affecting the CNS. Agarose isoelectrofocusing had the best diagnostic sensitivity (93%) for MS, combined with a low p+ (0-19%) for other diseases. Among the formulae, the IgG extended index and Reiber's hyperbolic formula were equivalent, giving high (75-79%) diagnostic sensitivity for MS combined with low p+ (4-22%) for other diseases. All other formulae, although sensitive for MS, had a higher rate of false positive results.

Topics: Algorithms; Humans; Immunoglobulin G; Isoelectric Focusing; Meningitis; Multiple Sclerosis; Nervous System Diseases; Polyradiculoneuropathy; Reference Values; Sensitivity and Specificity; Sepharose

Agarose isoelectric focusing (AIEF) of concentrated CSF was compared with AIEF of unconcentrated CSF and subsequent immunofixation with radiolabeled antihuman IgG Fc Fragment antiserum and autoradiography for the demonstration of oligoclonal bands in CSF from 287 neurological patients. Oligoclonal bands were demonstrated by AIEF in 98% of 43 patients with multiple sclerosis, 72% of 18 patients with infectious CNS diseases, and 23% of 226 patients with other neurological diseases. The corresponding figures obtained with AIEF of unconcentrated CSF and radioimmunofixation were 98%, 67% and 21%, respectively. In 15 of the patients, oligoclonal bands were demonstrated in CSF and serum by both techniques. They are both useful alternatives for the demonstration of oligoclonal bands in CSF, and the method for unconcentrated CSF can be safely applied when only small CSF volumes are available. The oligoclonal IgG pattern obtained by AIEF was not influenced by concentration of CSF by ultrafiltration and subsequent dilution to the original IgG concentration, nor by storage for 6 months.

Topics: Adult; Aged; Female; Humans; Immunoglobulins; Immunologic Techniques; Iodine Radioisotopes; Isoelectric Focusing; Male; Meningitis; Meningoencephalitis; Middle Aged; Multiple Sclerosis; Nervous System Diseases; Oligoclonal Bands; Polysaccharides; Preservation, Biological; Sepharose; Specimen Handling