Petzold, Axel;
(2013)
Intrathecal oligoclonal IgG synthesis in multiple sclerosis.
Journal of Neuroimmunology
, 262
(1-2)
pp. 1-10.
10.1016/j.jneuroim.2013.06.014.
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Abstract
The diagnosis of multiple sclerosis is based on dissemination in time and space. Before 2010 lack of evidence for dissemination in space could be substituted by a paraclinical test, cerebrospinal fluid (CSF) oligoclonal bands (OCBs). The present meta-analysis (13,467 patients) shows that the diagnostic specificity of OCB drops from 94% to 61% if inflammatory etiologies are considered. Importantly, this was not caused by poor laboratory practice. This review on CSF OCB further illustrates the conceptional problem of substituting dissemination in space with a biomarker. The potential prognostic value of intrathecal OCB will need to be tested prospectively. © 2013 Elsevier B.V. All rights reserved.
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