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Clinical significance of a single cerebrospinal fluid immunoglobulin band: A retrospective study
Maud Tusseau1, Estelle Cheli1, Romain Marignier2
1Hospices Civils de Lyon, Laboratoire d'immunologie, Hôpital Édouard Herriot, Lyon, France.
Insights
A single immunoglobulin (Ig) band in cerebrospinal fluid (CSF) may indicate an inflammatory neurological disorder. This finding warrants further investigation, especially when clinical signs suggest inflammation.
Area of Science:
- Neurology
- Immunology
- Clinical Diagnostics
Background:
- Central nervous system inflammation diagnosis typically requires at least two immunoglobulin (Ig) bands in cerebrospinal fluid (CSF).
- A single abnormal Ig band in CSF has historically been interpreted as a negative result.
Purpose of the Study:
- To retrospectively evaluate the clinical significance of detecting a single Ig band in CSF.
- To determine if a single CSF Ig band can serve as a biomarker for inflammatory neurological disorders.
Main Methods:
- Retrospective analysis of 10,286 CSF analyses.
- Identification and review of 214 cases with single Ig bands detected in CSF.
Main Results:
- An inflammatory neurological disorder was diagnosed in 41% of patients with a single CSF Ig band.
- The presence of a single Ig band, while not highly sensitive, was associated with inflammatory processes.
Conclusions:
- A single CSF Ig band can be a potential biomarker for underlying inflammatory mechanisms in the central nervous system.
- Clinicians should consider repeating CSF analysis if a single Ig band is detected and the clinical suspicion for inflammation remains high.
Background:
To demonstrate an inflammatory process in the central nervous system, the presence of at least two immunoglobulin (Ig) bands in the cerebrospinal fluid (CSF) is required. So far, the presence of a single abnormal Ig band is considered as negative.
Objective:
The objective was to assess retrospectively the significance of a single CSF Ig band in clinical practice.
Methods And Results:
Out of 10,286 CSF analyses, we retained 214 results with single Ig. An inflammatory neurological disorder was diagnosed in 41% of patients.
Conclusion:
Despite a modest sensitivity, the presence of a single CSF Ig band may be a biomarker of an inflammatory mechanism and, as such, may prompt the clinician to repeat the analysis when the clinical context remains suggestive.
