BACKGROUND: Intrathecal IgM synthesis demonstrated either as cerebrospinal fluid (CSF)-restricted oligoclonal (o-) IgM bands or calculated using various formulas has been linked to more aggressive multiple sclerosis (MS) course. However, the proportion of MS patients showing intrathecal IgM synthesis varies largely between studies. We aimed to explore the relation between different formulas and results of o-IgM, and to assess the frequency of o-IgM bands in an unselected series of samples. METHODS: 432 samples were analyzed for o-IgM, o-IgG and quantitative measures of IgM and IgG synthesis. IgM index and formulas of Reiber, Auer and Öhman were compared to the result of the o-IgM test. RESULTS: At the cut-off commonly used, the non-linear formulas for intrathecal synthesis were specific (>94%) but rather insensitive (<40% even at a cut-off of 4 CSF-restricted bands) compared to o-IgM. No significant difference was noted in the performance of different formulas. At a cut-off of 4 bands, 61% of MS patients, but none of the controls were positive for o-IgM. CONCLUSIONS: Formulas for intrathecal IgM synthesis are insensitive compared to o-IgM. We propose to evaluate samples with 2 or 3 extra-CSF IgM bands as borderline and only samples with 4 or more as definitely positive.
- MeSH
- imunoglobulin M MeSH
- lidé MeSH
- oligoklonální proužky * MeSH
- roztroušená skleróza * diagnóza MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
Oběh i ventilace, tedy základní životní funkce, jsou zprostředkovány svaly. Myokard, převodní srdeční systém i příčně pruhované dýchací svaly podléhají u myopatií výrazným změnám. V přehledu uvádíme myopatie, pro které je kardiorespirační nedostatečnost typická, patofyziologický podtext těchto změn, jejich klinické projevy a možnost včasného záchytu a léčby.
Circulation and breathing, as the basic life functions, are mediated by muscles. Myocardium, as well as the conduction system of the heart and the respiratory muscles are affected in myopathy. In the overview we present myopathies often manifesting with cardiorespiratory insufficiency. We discuss pathophysiological background of these changes, their clinical manifestations and options of early diagnosis and treatment.
- MeSH
- Duchennova muskulární dystrofie komplikace patofyziologie MeSH
- elektrokardiografie MeSH
- kardiomyopatie diagnóza etiologie farmakoterapie MeSH
- lidé MeSH
- myotonická dystrofie komplikace MeSH
- nemoci srdce * komplikace MeSH
- pletencové svalové dystrofie komplikace patofyziologie MeSH
- respirační insuficience diagnóza komplikace terapie MeSH
- svalové dystrofie * komplikace MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH
AIMS: To compare the sensitivity and specificity of CSF-restricted oligoclonal IgG and free light chains as markers of multiple sclerosis and other inflammatory neurological diseases. METHODS: 196 paired CSF and serum samples were examined for oligoclonal IgG and oligoclonal free light chains. The sensitivity and specificity of the tests were calculated and optimal cut-offs for the number of CSF-restricted oligoclonal bands were then determined by analysis of receiver operating characteristic curves. RESULTS: Optimal cut-off values were ≥5 IgG bands for multiple sclerosis, ≥4 IgG bands for inflammatory neurological disease, ≥6 free κ, and ≥2 free λ bands for both purposes. Using these cut-off values, sensitivities and specificities for multiple sclerosis were 83.8% and 91.3% for IgG, 83.8% and 81.0% for free κ, and 67.6% and 75.4% for free λ. For inflammatory neurological disease, sensitivities and specificities were 60.8% and 95.7% for IgG, 69.6% and 92.6% for free κ, and 64.8% and 86.2% for free λ. CONCLUSIONS: Although exact cut-off values may vary according to method, reporting borderline results as positive, may compromise the specificity of the test and should be avoided.. The detection of intrathecal free light chain synthesis may be of value especially when the oligoclonal IgG test is negative or borderline, even though its specificity is slightly lower.
- MeSH
- biologické markery MeSH
- imunoglobulin G MeSH
- lidé MeSH
- oligoklonální proužky MeSH
- reprodukovatelnost výsledků MeSH
- roztroušená skleróza MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- srovnávací studie MeSH
- Publikační typ
- abstrakt z konference MeSH
