Measurement of cerebrospinal fluid IgG in the diagnosis of multiple sclerosis.

E W Willoughby
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Abstract

CSF IgG was measured in 190 patients by Single Radial Immunodiffusion, A high value for the ratio CSF IgG/total protein (normal values being up to 14%) was obtained in 13 of 22 patients (54%) with definite or probable multiple sclerosis and in 16 of 137 patients (12%) with other neurological disorders excluding acute infections, subarachnoid haemorrhage and neurosyphilis. In 56 patients IgG and albumin were measured in CSF and serum using Rocket Immunoelectrophoresis (Electroimmunodiffusion) and results assessed by dividing the radio IgG/albumin in the CSF by the same ratio in the serum to obtain an Index. Because of the small number of normal patients, it was not possible to define a normal range but separation of patients with multiple sclerosis from those with other neurological disorders was even less clear-cut than with first method. Minor technical difficulties with the Rocket technique and prolonged storage of some of the specimens may at least partly explain the discouraging results with this method. It was concluded that the measurement of CSF IgG was of limited value to a clinican attempting to make a diagnosis in an individual patient with neurological disease.

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脑脊液IgG检测对多发性硬化症的诊断价值。
在22例明确或可能多发性硬化症患者中的13例(54%)和137例除急性感染、蛛网膜下腔出血和神经梅毒外的其他神经系统疾病患者中的16例(12%)中,脑脊液IgG/总蛋白的比值较高(正常值高达14%)。采用火箭免疫电泳(电免疫扩散)法测定56例患者脑脊液和血清中IgG和白蛋白的含量,并将脑脊液中IgG/白蛋白的比值与血清中IgG/白蛋白的比值相比较,得出指标。由于正常患者数量少,不可能确定正常范围,但与第一种方法相比,多发性硬化症患者与其他神经系统疾病患者的分离甚至更不明确。火箭技术的小技术困难和一些标本的长期储存至少可以部分解释这种方法令人沮丧的结果。结论是,脑脊液IgG的测量是有限的价值,临床医生试图作出诊断的个别病人的神经系统疾病。
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