Contributions
Abstract: P462
Type: Poster
Abstract Category: Pathology and pathogenesis of MS - Progressive MS
Introduction: Cerebrospinal fluid (CSF) analysis remains an important part to establish the diagnosis in patients with primary progressive multiple sclerosis (PPMS). Most of previous studies regarding CSF data of PPMS patients suffer from small samples size.
Methods: We retrospectively evaluated CSF data obtained from PPMS patients (McDonald criteria 2010) seen between 2009 and 2014 in four tertiary hospitals in Germany (Ulm, Frankfurt, Freiburg and Rostock). The basic CSF parameters (cell count, lactate, albumin CSF/serum quotient (QALB), immunoglobulin indices and oligoclonal bands (OCB)) were analyzed in correlation with the Expanded Disability Status Scale (EDSS) at time of first LP (EDSSLP) as well as the progression rate.
Results: A total of 254 patients were included. The median EDSSLP was 4.0. The median cell count was within normal range. The QALB was elevated in 29.6 %. Intrathecal OCB were detectable in 91.1 %. The median index for IgG, IgM and IgA were 0.8, 0.06 and 0.3, respectively. We found no statistically significant correlation between the markers of immunoglobulin synthesis in CSF and the clinical parameters. Median CSF-lactate was within reference range. However, it showed a statistically significant positive correlation with the disease progression rate (spearman correlation =0.3, p= 0.02 ).
Discussion: To our knowledge, this cohort of PPMS-patients with complete CSF data represents one of the largest published. The high incidence of intrathecal IgG production could highlight the inflammatory nature of the PPMS, which may explain the success of B cell depleting therapies in PPMS. Apart from CSF-lactate we found no correlation between the CSF parameters and clinical severity of the disease.
Disclosure: No conflict of interest
Abstract: P462
Type: Poster
Abstract Category: Pathology and pathogenesis of MS - Progressive MS
Introduction: Cerebrospinal fluid (CSF) analysis remains an important part to establish the diagnosis in patients with primary progressive multiple sclerosis (PPMS). Most of previous studies regarding CSF data of PPMS patients suffer from small samples size.
Methods: We retrospectively evaluated CSF data obtained from PPMS patients (McDonald criteria 2010) seen between 2009 and 2014 in four tertiary hospitals in Germany (Ulm, Frankfurt, Freiburg and Rostock). The basic CSF parameters (cell count, lactate, albumin CSF/serum quotient (QALB), immunoglobulin indices and oligoclonal bands (OCB)) were analyzed in correlation with the Expanded Disability Status Scale (EDSS) at time of first LP (EDSSLP) as well as the progression rate.
Results: A total of 254 patients were included. The median EDSSLP was 4.0. The median cell count was within normal range. The QALB was elevated in 29.6 %. Intrathecal OCB were detectable in 91.1 %. The median index for IgG, IgM and IgA were 0.8, 0.06 and 0.3, respectively. We found no statistically significant correlation between the markers of immunoglobulin synthesis in CSF and the clinical parameters. Median CSF-lactate was within reference range. However, it showed a statistically significant positive correlation with the disease progression rate (spearman correlation =0.3, p= 0.02 ).
Discussion: To our knowledge, this cohort of PPMS-patients with complete CSF data represents one of the largest published. The high incidence of intrathecal IgG production could highlight the inflammatory nature of the PPMS, which may explain the success of B cell depleting therapies in PPMS. Apart from CSF-lactate we found no correlation between the CSF parameters and clinical severity of the disease.
Disclosure: No conflict of interest