Is primary orthostatic tremor associated with an autochthonous immunoglobulin synthesis in the cerebrospinal fluid?

2005 ◽  
Vol 20 (8) ◽  
pp. 1079-1080
Author(s):  
Joerg Spiegel ◽  
Gerhard Fuss ◽  
Ulrich Dillmann
Keyword(s):  
Cerebrospinal Fluid ◽  
Orthostatic Tremor ◽  
Immunoglobulin Synthesis

scholarly journals Kappa Free Light Chains in Cerebrospinal Fluid as Markers of Intrathecal Immunoglobulin Synthesis

2004 ◽  
Vol 50 (10) ◽  
pp. 1809-1813 ◽  
Author(s):  
Christian Fischer ◽  
Borros Arneth ◽  
Jürgen Koehler ◽  
Johannes Lotz ◽  
Karl J Lackner
Keyword(s):  
Cerebrospinal Fluid ◽  
Diagnostic Accuracy ◽  
Barrier Function ◽  
High Specificity ◽  
Oligoclonal Bands ◽  
Light Chains ◽  
Free Light Chains ◽  
Blood Contamination ◽  
Immunoglobulin Synthesis ◽  
Specificity And Sensitivity

Abstract Background: Intrathecal immunoglobulin synthesis is observed in several inflammatory disorders of the central nervous system, but its detection by current laboratory tests is either tedious or relatively insensitive. We assessed the diagnostic accuracy of an assay for κ free light chains (κFLC) in cerebrospinal fluid (CSF) and serum, and compared it with traditional tests for intrathecal immunoglobulin synthesis. Methods: κFLCs were measured by nephelometry in CSF/serum pairs from 112 patients. Samples were excluded if blood contamination of CSF as a result of traumatic lumbar puncture (n = 12) or monoclonal bands in both CSF and serum (n = 5) were present. The remaining sample pairs were grouped according to the presence (n = 71) or absence (n = 24) of oligoclonal bands. Data were analyzed as κFLC concentrations in CSF, as κFLC CSF/serum ratios, and by use of the quotient diagram described previously for immunoglobulins. Results: Both κFLC concentrations in CSF and the κFLC CSF/serum ratio identified patients with oligoclonal bands with high specificity and sensitivity. The areas under the ROC curves were 0.991 (95% confidence interval, 0.944–0.998) and 0.978 (0.924–0.996), respectively. Exclusion of patients with impaired blood–CSF barrier function further improved diagnostic accuracy. To account for patients with impaired blood–CSF barrier function, data were also analyzed in a quotient diagram. Only two patients without detectable oligoclonal bands would have been misclassified by this approach. Conclusions: Our data indicate that the nephelometric assay for κFLCs in CSF reliably detects intrathecal immunoglobulin synthesis. This automated and quantitative method could simplify the diagnostic procedure for CSF analysis in the routine laboratory.

scholarly journals Evidence of Oligoclonal Bands Does Not Exclude Non-Inflammatory Neurological Diseases

Diagnostics ◽  
2020 ◽  
Vol 11 (1) ◽  
pp. 37
Author(s):  
Katharina Pannewitz-Makaj ◽  
Ulrich Wurster ◽  
Konstantin Fritz Jendretzky ◽  
Stefan Gingele ◽  
Kurt-Wolfram Sühs ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Cerebrospinal Fluid ◽  
Nervous System ◽  
Neurological Diseases ◽  
Low Frequency ◽  
Epileptic Seizures ◽  
Oligoclonal Bands ◽  
Immunoglobulin Synthesis ◽  
Fluid Analysis ◽  
The Central Nervous System

Cerebrospinal fluid analysis is an essential part of the diagnostic workup in various neurological disorders. Evidence of an intrathecal immunoglobulin synthesis, as demonstrated by Reiber’s diagram or the more sensitive oligoclonal bands (OCB), are typical for neuroinflammatory diseases, and normally not expected in non-inflammatory neurological diseases. Therefore, patients with non-inflammatory neurological diseases are often used in control groups in studies investigating autoimmune diseases of the central nervous system. However, data about the frequency of intrathecal immunoglobulin synthesis in non-inflammatory neurological disease are scarce. The cerebrospinal fluid (CSF) records of a total of 3622 patients were screened and 2114 patients included with presumably non-inflammatory neurological diseases like dementia, idiopathic peripheral neuropathy, motoneuron disease, stroke, and epileptic seizures. Evidence of an intrathecal immunoglobulin synthesis can be found with low frequency also in non-inflammatory neurological diseases. A much higher rate of patients showed intrathecal immunoglobulin synthesis as demonstrated by OCB than by Reiber’s diagram. In patients with disorders of the peripheral nervous system the frequency of OCB was much lower than in patients presenting with central nervous system manifestations. Evidence of an intrathecal immunoglobulin synthesis should not automatically lead to exclusion of non-inflammatory neurological diseases but should rather prompt the way to investigate for the origin of the intrathecal immunoglobulin synthesis.

scholarly journals Results of Cerebrospinal Fluid Analysis in 108 Patients With Progressive Multifocal Leukoencephalopathy

2020 ◽  
Author(s):  
Nora Möhn ◽  
Luo Yi ◽  
Thomas Skripuletz ◽  
Philipp Schwenkenbecher ◽  
Anne Ladwig ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Progressive Multifocal Leukoencephalopathy ◽  
Cell Count ◽  
Normal Pressure ◽  
Control Group ◽  
Immunoglobulin Synthesis ◽  
Fluid Analysis ◽  
Natalizumab Treatment ◽  
Csf Lactate ◽  
The Central Nervous System

Abstract Background: Progressive multifocal leukoencephalopathy (PML) is caused by an opportunistic infection with JC polyoma virus (JCPyV) and mainly affects immunocompromised patients. It leads to pronounced demyelination of the central nervous system (CNS) resulting in severe disability or even death. Detection of JCPyV DNA in the cerebrospinal fluid (CSF) is usually accepted as proof for the diagnosis of PML. Values from routine CSF parameters, like CSF cell count, protein concentration, Qalbumin levels, or intrathecal immunoglobulin synthesis are mostly considered as normal; however, this has not been investigated systematically. Methods: We therefore analyzed those standard CSF parameters in a cohort of 108 PML patients that were treated at four different neurological centers in Germany. The patients exhibited different underlying conditions with natalizumab treatment in multiple sclerosis (n=54) and human immunodeficiency virus (HIV)-infection (n=25) being the most frequent. The data were collected at the respective centers in accordance with local requirements and then jointly analyzed. The results of the total PML cohort were compared with a control group of patients with normal pressure hydrocephalus (NPH) and idiopathic intracranial hypertension (IIH) or an HIV group without PML, respectively. Results: The PML group showed an elevated cell count (p<0.001) compared to the control group, however, this effect was mainly driven by HIV-PML patients. This subgroup also demonstrated a significantly higher proportion of patients with a disturbed blood-CSF-barrier function. Immune reconstitution syndrome (IRIS) occurred in 41/108 patients and was characterized by a trend for an increase in CSF cell count (p=0.052), CSF lactate (p=0.052), and an augmented intrathecal immunoglobulin synthesis. Conclusions: This comprehensive, retrospective study on diagnostic results in PML patients provides insight into the CSF findings in patients with PML. It demonstrates that CSF changes in PML patients may be specific for the underlying condition that predisposes for the development of PML and thus data have to be interpreted in this context.

The cerebrospinal fluid in multiple sclerosis. Quantitative assessment of intrathecal immunoglobulin synthesis by empirical formulae

1996 ◽  
Vol 3 (6) ◽  
pp. 548-559 ◽  
Author(s):  
F. Sellebjerg ◽  
M. Christiansen ◽  
L. S. Rasmussen ◽  
I. Jaliachvili ◽  
P. M. Nielsen ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cerebrospinal Fluid ◽  
Quantitative Assessment ◽  
Immunoglobulin Synthesis

Determination of kFLC and K Index in cerebrospinal fluid: A valid alternative to assessintrathecal immunoglobulin synthesis

2013 ◽  
Vol 263 (1-2) ◽  
pp. 116-120 ◽  
Author(s):  
Fabio Duranti ◽  
Massimo Pieri ◽  
Diego Centonze ◽  
Fabio Buttari ◽  
Sergio Bernardini ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Immunoglobulin Synthesis ◽  
K Index
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