Contributions
Abstract: P830
Type: Poster
Abstract Category: Clinical aspects of MS - Paediatric MS
Introduction: Pediatric MS may differ from the adult disease in clinical practice and in laboratory evaluation. MRI and routine laboratory tests appear to be insufficient, at times, to accurately diagnose pediatric MS. We have recently reported that analysis of immunoglobulin free light chain (FLC) monomers and dimers in the CSF might aid the diagnosis of adult MS (Kaplan et al, 2010, 2012& 2013). However, whether such approach is helpful in the diagnosis of pediatric MS still remains questionable.
Aims: To evaluate FLC monomer-dimer pattern analysis as a new diagnostic tool in pediatric MS.
Methods: Pediatric patients with definite MS (n=17) and other non-MS neurological disorders (n=24, used to determine specificity) were tested. Patients showing no evidence for demyelinating or inflammatory disease (n=8) were used as negative controls.
CSF and serum pairs were analyzed by our previously developed technique, which included quantitative Western blotting for the detection of FLC-κ and λ immunoreactive bands. Intensity of bands was measured to evaluate the levels of FLC monomers and dimers (Kaplan et al, 2010).
Results: All patients with definite MS demonstrated abnormal FLC monomer-dimer patterns, typical of MS (Kaplan et al, 2013). Three distinct pathological FLC profiles were observed. In 10 out of 17 MS patients, the highly increased CSF levels of κ monomers and dimers were demonstrated (“k type”). Four MS cases showed the abnormally increased λ dimer levels (“λ type”). In 3 MS patients, the increased κ-FLC levels were accompanied by highly elevated λ dimers (“mixed type”).
MRI and clinical assessment revealed that the “mixed” and “λ” type MS cases indicated a more aggressive form of the disease. In fact, 2 out of 3 “mixed type” patients and 3 out of 4 “λ type” patients demonstrated an increased number of T2 load lesions, more active disease and higher frequency of clinical relapses. In contrast, most “κ type” MS patients showed a moderately active course of the disease.
Diagnostic utility of our technique was evaluated. Both sensitivity (100%) and specificity (91%) of the FLC monomer-dimer analysis were higher than those of OCB test (87% and 83%, respectively).
Conclusions: Our preliminary results show that FLC monomer-dimer analysis in the CSF may aid the diagnosis and prognosis evaluation of pediatric MS.
Disclosure: "Esther Ganelin-Cohen- nothing to disclose"
"Batia Kaplan-nothing to disclose"
"Regina Yeskaraev-nothing to disclose"
"Avi LIvneh-nothing to disclose"
"Sizilia Golderman-nothing to disclose"
Abstract: P830
Type: Poster
Abstract Category: Clinical aspects of MS - Paediatric MS
Introduction: Pediatric MS may differ from the adult disease in clinical practice and in laboratory evaluation. MRI and routine laboratory tests appear to be insufficient, at times, to accurately diagnose pediatric MS. We have recently reported that analysis of immunoglobulin free light chain (FLC) monomers and dimers in the CSF might aid the diagnosis of adult MS (Kaplan et al, 2010, 2012& 2013). However, whether such approach is helpful in the diagnosis of pediatric MS still remains questionable.
Aims: To evaluate FLC monomer-dimer pattern analysis as a new diagnostic tool in pediatric MS.
Methods: Pediatric patients with definite MS (n=17) and other non-MS neurological disorders (n=24, used to determine specificity) were tested. Patients showing no evidence for demyelinating or inflammatory disease (n=8) were used as negative controls.
CSF and serum pairs were analyzed by our previously developed technique, which included quantitative Western blotting for the detection of FLC-κ and λ immunoreactive bands. Intensity of bands was measured to evaluate the levels of FLC monomers and dimers (Kaplan et al, 2010).
Results: All patients with definite MS demonstrated abnormal FLC monomer-dimer patterns, typical of MS (Kaplan et al, 2013). Three distinct pathological FLC profiles were observed. In 10 out of 17 MS patients, the highly increased CSF levels of κ monomers and dimers were demonstrated (“k type”). Four MS cases showed the abnormally increased λ dimer levels (“λ type”). In 3 MS patients, the increased κ-FLC levels were accompanied by highly elevated λ dimers (“mixed type”).
MRI and clinical assessment revealed that the “mixed” and “λ” type MS cases indicated a more aggressive form of the disease. In fact, 2 out of 3 “mixed type” patients and 3 out of 4 “λ type” patients demonstrated an increased number of T2 load lesions, more active disease and higher frequency of clinical relapses. In contrast, most “κ type” MS patients showed a moderately active course of the disease.
Diagnostic utility of our technique was evaluated. Both sensitivity (100%) and specificity (91%) of the FLC monomer-dimer analysis were higher than those of OCB test (87% and 83%, respectively).
Conclusions: Our preliminary results show that FLC monomer-dimer analysis in the CSF may aid the diagnosis and prognosis evaluation of pediatric MS.
Disclosure: "Esther Ganelin-Cohen- nothing to disclose"
"Batia Kaplan-nothing to disclose"
"Regina Yeskaraev-nothing to disclose"
"Avi LIvneh-nothing to disclose"
"Sizilia Golderman-nothing to disclose"