Contributions
Abstract: EP1281
Type: ePoster
Abstract Category: Clinical aspects of MS - 1 Diagnosis and differential diagnosis
Background: Neurosarcoidosis affects between 5-10 % of all sarcoidosis patients and is a major differential diagnosis to multiple sclerosis. Diagnosing neurosarcoidosis becomes particularly difficult when it appears primarily in the nervous system and is a challenge to the neurologist. It has previously been suggested that an elevated cerebrospinal (CSF) CD4+/CD8+ ratio >5 can be an aid in diagnosing neurosarcoidosis.
Method: In this study we studied the cases of 66 patients who were subject to the analysis of CSF CD4+/CD8+ ratio by flow cytometry where neurosarcoidosis was a differential diagnosis. The final diagnoses from patient charts were sub-grouped into sarcoidosis, other neuroinflammation and non-inflammation.
Results: We found 11 cases of neurosarcoidosis who, as a group, had a higher mean CSF CD4+/CD8+ ratio than the other two groups, with a significant difference only against the non-inflammatory group.
The mean CSF CD4+/CD8+ ratio was 4.39, hence not reaching the suggested level of >5 for diagnosing neurosarcoidosis. We added the elevated CSF CD4+/CD8+ value >5 together with an elevated CSF lymphocyte count (2xULN) and found a positive predictive value of 60 % and a high negative predictive value of 92 %.
Interpretation: CSF CD4+/CD8+ ratio >5 measured by flow-cytometry in combination with elevated lymphocyte-count is a method the can be utilzed in diagnostic workup in neurosarcoidosis.
Disclosure:
CM has recived lecture honoraria and served on AdBoards for Biogen, Merck, Novartis and Sanofi-Aventis.
SN and BA has no conflict of interest and nothing to disclose.
Abstract: EP1281
Type: ePoster
Abstract Category: Clinical aspects of MS - 1 Diagnosis and differential diagnosis
Background: Neurosarcoidosis affects between 5-10 % of all sarcoidosis patients and is a major differential diagnosis to multiple sclerosis. Diagnosing neurosarcoidosis becomes particularly difficult when it appears primarily in the nervous system and is a challenge to the neurologist. It has previously been suggested that an elevated cerebrospinal (CSF) CD4+/CD8+ ratio >5 can be an aid in diagnosing neurosarcoidosis.
Method: In this study we studied the cases of 66 patients who were subject to the analysis of CSF CD4+/CD8+ ratio by flow cytometry where neurosarcoidosis was a differential diagnosis. The final diagnoses from patient charts were sub-grouped into sarcoidosis, other neuroinflammation and non-inflammation.
Results: We found 11 cases of neurosarcoidosis who, as a group, had a higher mean CSF CD4+/CD8+ ratio than the other two groups, with a significant difference only against the non-inflammatory group.
The mean CSF CD4+/CD8+ ratio was 4.39, hence not reaching the suggested level of >5 for diagnosing neurosarcoidosis. We added the elevated CSF CD4+/CD8+ value >5 together with an elevated CSF lymphocyte count (2xULN) and found a positive predictive value of 60 % and a high negative predictive value of 92 %.
Interpretation: CSF CD4+/CD8+ ratio >5 measured by flow-cytometry in combination with elevated lymphocyte-count is a method the can be utilzed in diagnostic workup in neurosarcoidosis.
Disclosure:
CM has recived lecture honoraria and served on AdBoards for Biogen, Merck, Novartis and Sanofi-Aventis.
SN and BA has no conflict of interest and nothing to disclose.