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CC BY 4.0 · Arq Neuropsiquiatr 2024; 82(03): s00441779690
DOI: 10.1055/s-0044-1779690
Original Article

Concordance rate between oligoclonal bands and the Kappa index in patients with suspected multiple sclerosis (MS)

Concordância entre bandas oligoclonais e o índice Kappa em pacientes com suspeita de esclerose múltipla (EM)
Renan Barros Domingues 
1   Senne Liquor Diagnóstico, São Paulo SP, Brazil.
,
Márcio Vega dos Santos 
1   Senne Liquor Diagnóstico, São Paulo SP, Brazil.
,
Daiane Salomão 
1   Senne Liquor Diagnóstico, São Paulo SP, Brazil.
,
Carlos Senne 
1   Senne Liquor Diagnóstico, São Paulo SP, Brazil.
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Abstract

Background Oligoclonal bands (OCBs) and Kappa free light chains (FLCs) in the cerebrospinal fluid (CSF) are sensitive markers of intrathecal immunoglobulin (Ig)G synthesis in patients with multiple sclerosis.

Objective To evaluate the concordance rate between OCBCs and the Kappa index (KI) in patients with suspected multiple sclerosis (MS).

Methods Patients with suspected MS were referred to a specialized CSF laboratory as part of their diagnostic investigation. Paired CSF and serum samples were collected and submitted to detection of OCBs and determination of the KI. Positive and negative results were determined with both methods, and the percentage of agreement between them was established.

Results In total, 171 serum and CSF samples from 171 patients were included in the analysis. The mean age of the patients was of 40 ± 14.2 years; 18.9% of them were male, and 81.1% were female. The OCBs and KI presented concordant results in 161 (94.2%) samples: in 74 (43.3%), both were positive, and in 87 (50.9%), both were negative. In 10 cases, the results were discrepant: KI positive/OCB negative in 8 and OCB positive/KI negative in 2 cases.

Conclusion The KI and OCBs presented high concordance level. Currently, the detection of OCBs in the CSF is the standard method for MS diagnosis, but it is time-consuming, and its visual interpretation can be difficult. The results suggest that the KI is a good alternative for the detection of intrathecal immunoproduction in cases of suspected MS.

Resumo

Antecedentes Bandas oligoclonais (BOCs) e cadeias leves de imunoglobulina (free light chains, FLCs, em inglês) Kappa no líquido cefalorraquidiano (LCR) são marcadores sensíveis da síntese intratecal de imunoglobulina (Ig)G em pacientes com esclerose múltipla (EM).

Objetivo Avaliar a taxa de concordância entre BOCs e o índice Kappa (IK) em pacientes com suspeita de EM.

Métodos Pacientes com suspeita de EM foram encaminhados a um laboratório especializado em LCR como parte de sua investigação diagnóstica. Amostras pareadas de LCR e soro foram coletadas e investigadas quanto à presença de BOCs e submetidas à determinação do IK. Resultados positivos e negativos foram determinados com ambos os métodos, e estabeleceu-se o percentual de concordância entre eles.

Resultados Ao todo, 171 amostras de soro e LCR de 171 pacientes foram incluídas na análise. A média de idade dos pacientes foi de 40 ± 14,2 anos; 18,9% deles eram do sexo masculino, e 81,1%, do sexo feminino. Resultados concordantes entre as BOCs e o IK foram observados em 161 (94,2%) amostras: em 74 (43,3%), ambos foram positivos, e em 87 (50,9%), ambos foram negativos. Em 10 casos, os resultados foram discrepantes: IK positivo/BOC negativo em 8, e BOC positivo/IK negativo em 2.

Conclusão Observou-se alto nível de concordância entre o IK e as BOCs. A detecção de BOCs no LCR é atualmente o método padrão para o diagnóstico de EM, mas é demorado, e sua interpretação visual pode ser difícil. Os resultados sugerem que o IK pode ser uma alternativa para a detecção de imunoprodução intratecal em casos de suspeita de EM.

Keywords

Multiple Sclerosis - Immunoglobulin kappa-Chains - Cerebrospinal Fluid - Oligoclonal Bands - Immunoglobulin Light Chains

Palavras-chave

Esclerose Múltipla - Cadeias kappa de Imunoglobulina - Líquido Cefalorraquidiano - Bandas Oligoclonais - Cadeias Leves de Imunoglobulina

Authors' Contributions

RBD: conceptualization, data curation, formal analysis, investigation, methodology, supervision, validation, visualization, writing of original draft, and writing – review and editing; MVS: methodology, validation, visualization, and writing – review and editing; DS: data curation, formal analysis, methodology, project administration, and writing – review and editing; and CS: funding acquisition, methodology, project administration, resources, supervision, visualization, and writing – review and editing.




Publication History

Received: 17 August 2023

Accepted: 25 December 2023

Article published online:
14 March 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

Thieme Revinter Publicações Ltda.
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Bibliographical Record
Renan Barros Domingues, Márcio Vega dos Santos, Daiane Salomão, Carlos Senne. Concordance rate between oligoclonal bands and the Kappa index in patients with suspected multiple sclerosis (MS). Arq Neuropsiquiatr 2024; 82: s00441779690.
DOI: 10.1055/s-0044-1779690
 

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