Contributions
Abstract: P840
Type: Poster
Abstract Category: Clinical aspects of MS - 1 Diagnosis and differential diagnosis
Previous studies have demonstrated the utility of kappa (K) free light chains (FLCs) in cerebrospinal fluid (CSF) as an alternative to oligoclonal bands (OCB) in the diagnosis of multiple sclerosis (MS).However, these findings have not been confirmed in a Latin American population.The objective of this study was to determine the sensitivity and specificity of KFLC (K) and lambda (L) FLCs in CSF for the diagnosis of MS in Buenos Aires, Argentina.
Methods: Paired CSF and serum samples from 83 patients including MS and other neurological disease(non-MS), were collected between 2015 and 2017. OCB were analyzed by isoelectric focusing followed by immunofixation (SEBIA, Hydragel CSF). CSF and serum FLC were measured using the FLC immunoassay Freelite™(The Binding Site, Birmingham, UK) on a SPAPLUS analyzer according to the manufacturer's instructions and expressed as median±[SD]. Results were correlated with the patient´s diagnosis. Receiver operating characteristic (ROC) curve analysis was used to determine the optimal sensitivity and specificity.
Results: In the MS group (n = 41), CSF KFLCs were highly elevated (7.5 mg/L ±3.2), and CSF LFLCs were moderately elevated (0.4 mg/L ±0.22) compared to K and LFLCs in controls with other neurological diseases (1.7 mg/L ±2.3 and 0.2 mg/L ±0.03, respectively). 93% of MS patients and 9.5% of the non-MS were OCB positive, resulting in a diagnostic sensitivity and specificity of 93% and 90.4%. The optimal cut-off for KFLCs determined by ROC was 7 mg/L, with a diagnostic sensitivity and specificity of 95% and 97%, respectively. The optimal cut-off for LFLCs was 0.7 mg/L, with a diagnostic sensitivity and specificity of 71% and 81%, respectively.
Conclusion: KFLCs have a higher sensitivity and specificity for the diagnosis of MS than traditional OCB testing, and FLC analysis has the additional advantage of being an automated immunoassay that is simple to perform and interpret.
Disclosure: No funding
Abstract: P840
Type: Poster
Abstract Category: Clinical aspects of MS - 1 Diagnosis and differential diagnosis
Previous studies have demonstrated the utility of kappa (K) free light chains (FLCs) in cerebrospinal fluid (CSF) as an alternative to oligoclonal bands (OCB) in the diagnosis of multiple sclerosis (MS).However, these findings have not been confirmed in a Latin American population.The objective of this study was to determine the sensitivity and specificity of KFLC (K) and lambda (L) FLCs in CSF for the diagnosis of MS in Buenos Aires, Argentina.
Methods: Paired CSF and serum samples from 83 patients including MS and other neurological disease(non-MS), were collected between 2015 and 2017. OCB were analyzed by isoelectric focusing followed by immunofixation (SEBIA, Hydragel CSF). CSF and serum FLC were measured using the FLC immunoassay Freelite™(The Binding Site, Birmingham, UK) on a SPAPLUS analyzer according to the manufacturer's instructions and expressed as median±[SD]. Results were correlated with the patient´s diagnosis. Receiver operating characteristic (ROC) curve analysis was used to determine the optimal sensitivity and specificity.
Results: In the MS group (n = 41), CSF KFLCs were highly elevated (7.5 mg/L ±3.2), and CSF LFLCs were moderately elevated (0.4 mg/L ±0.22) compared to K and LFLCs in controls with other neurological diseases (1.7 mg/L ±2.3 and 0.2 mg/L ±0.03, respectively). 93% of MS patients and 9.5% of the non-MS were OCB positive, resulting in a diagnostic sensitivity and specificity of 93% and 90.4%. The optimal cut-off for KFLCs determined by ROC was 7 mg/L, with a diagnostic sensitivity and specificity of 95% and 97%, respectively. The optimal cut-off for LFLCs was 0.7 mg/L, with a diagnostic sensitivity and specificity of 71% and 81%, respectively.
Conclusion: KFLCs have a higher sensitivity and specificity for the diagnosis of MS than traditional OCB testing, and FLC analysis has the additional advantage of being an automated immunoassay that is simple to perform and interpret.
Disclosure: No funding