Clinical Values of Immunoglobulin in Cerebrospinal Fluid

J Korean Neurol Assoc > Volume 9(4); 1991 > Article

Journal of the Korean Neurological Association 1991;9(4): 418-424.

뇌척수액에서 면역글로부린의 임상적 가치

박성파, 이용희,임정근,이동국,이상도,박영춘,서정규

계명대학교 신경과.

Clinical Values of Immunoglobulin in Cerebrospinal Fluid

Sung Pa Park, M.D., Yong Hee Lee, M.D., Jeong Geun Lim, M.D., Dong Kuck Lee, M.D., Sang Doe Yi, M.D., Young Choon Park, M.D. Chung Kyu Suh, M.D.*

Dep. Of Neurology, Keimyung University Dep. Of Neurology, Kyungpook National University*

Abstract

We studied on 263 patients (20 with multiple sclerosis (MS); 243 with other neurological diseases (OND), I.e., 87 with myelopathy of unknown origin (MUO), 27 with central nervous system (CNS) infection, 31 with peripheral neuropathy (PN), 23 with cerebrovascular accident (CVA), and 75 with miscellaneous diseases (MD)), who were admitted to the Keimyung University Dongsan Hospital between January 1985 and April 1991 to analyze the clinical values of the cerebrospinal fluid (CSF) Ig G in MS and OND with quantitative CSF Ig G, Ig G-albumin ratio and Ig index by immunodiffusion method, and to detect oligoclonal bands in CSF of 21 patients (2 with MS, 15 with MUO, 1 with PN, 1 with CVA and 2 with MD) by agarose-gel electrophoresis. The results were summarized as follows: 1) In the frequency of elevated quantitative CSF Ig G measurements in patients with MS, the Ig G index was 64% (9 of 14 patients), higher than those of the Ig G and Ig G-albumin ratio, but in OND, the Ig G-albumin ratio was 30% (73 of 240 patients), higher than those of the Ig G and Ig G index. 2) In the frequencies of elevated quantitative CSF Ig G measurements, the Ig G levels in CNS infection, CVA and PN were 67%, 35% and 29%, respectivelyl higher than 25% in MS, and the Ig G-albumin ratio in CNS infection and CVA were 63% and 35%, respectively, higher than 32% in MS, but the Ig G index was the highest in MS (64%) followed by CNS infection (54%). 3) In validity of the various CSF Ig G measurements for diagnosis of MS, the Ig G index was the most sensitive test at 064, the Ig G was the most specific test at 0.76, and the Ig G index had the most positive and negative predictive values at 0.16 and 0.96, respectively. 4) Oligoclonal bands in CSF are not detected in all of 21 patients.