MULTIPLE SCLEROSIS PROFILE WITH MBP

Code
000.0000
Name
MULTIPLE SCLEROSIS PROFILE WITH MBP
Category
None
Department
Send-Out
Start Date
Expiration Date
Synonyms
MS Profile with MBP, Oligoclonal Banding Profile with MBP
CPT Codes
82040; 82042; 82784x2; 83873; 83916
Site
SBMF
Reference Test
35384
ATLAS Test Code

Specimen Information

Type

CSF AND Gold, SST

Volume

CSF: 1.5 mL
Serum: 1.0 mL

Transport Info

If CSF is bloody, centrifuge the sample and separate supernatant from cells
Separate serum from cells ASAP or within 2 hours of collection
Refrigerated

Fasting Required?
False
Patient Instructions

Reference Range

See Report

Methodology

Qualitative Isoelectric Focusing/Electrophoresis
Photometry and nephelometry
Enzyme-Linked Immunosorbent Assay (ELISA)

Clinical Significance

Oligoclonal banding is used in the diagnosis of multiple sclerosis (MS) and other diseases of the central nervous system.

The laboratory finding most useful in the evaluation of a patient suspected to have multiple sclerosis (MS) is increased production of IgG in the central nervous system. Increased production of CSF IgG is assessed by measuring the amount of IgG and albumin in serum and in CSF, then evaluating the level of CSF IgG, the CSF IgG index, CSF IgG synthesis rate, and CSF IgG/Albumin ratio. Oligoclonal bands are present in the CSF of approximately 90 percent of MS patients. A patient is considered positive for CSF oligoclonal bands if there are two or more bands in the CSF immunoglobulin region that are not present in the serum. In order to confirm local production of oligoclonal IgG in CSF, a matched serum sample is required. Oligoclonal bands present in CSF, but not in serum, indicate central nervous system production. Oligoclonal bands are performed using isoelectric focusing and immunofixation. The albumin index is used to rule out leakage of protein into the CSF from blood, either through a damaged blood brain barrier or traumatic spinal tap. Leakage of protein from the plasma into the CSF may cause a false elevation of the IgG Index or IgG synthesis rate. During active demyelinization, elevated levels of myelin basic protein (MBP) may be observed. Oligoclonal bands and elevated levels of CSF IgG may be present in other disease states, including meningoencephalitis, neurosyphilis, Guillain-Barré syndrome, and meningeal carcinomatosis. Up to ten percent of patients with clinically supported MS are negative for oligoclonal bands.

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