IgG synthesis rate in evaluation of multiple sclerosis in a community hospital

We obtained CSF and serum from 21 patients with definite MS in a community hospital. Ninety percent of patients had an elevated IgG synthesis rate, comparable with the sensitivity of oligoclonal bands (0.95) or the IgG index (0.90) and better than the IgG% (0.47) in definite MS. We found that no area hospital routinely employs the IgG synthesis rate. The low-sensitivity IgG% and the dimensionless IgG index can be abandoned. The linear IgG synthesis rate and oligoclonal band scanning should be the CSF tests of choice.