The kappa free light chains index is an accurate diagnostic biomarker for paediatric multiple sclerosis.

IF 4.8 2区医学 Q1 CLINICAL NEUROLOGY Multiple Sclerosis Journal Pub Date : 2024-10-01 Epub Date: 2024-09-08 DOI:10.1177/13524585241274034

Aurélie Sarthou, Pascale Chrétien, Laetitia Giorgi, Andrada Chiron, Carole Leroy, Philippe Horellou, Roman Krzysiek, Kumaran Deiva, Salima Hacein-Bey-Abina

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Abstract

Background: Multiple sclerosis (MS) may occur before the age of 18. Differentiation between paediatric MS (PedMS) and other demyelinating syndromes (ODSs) is challenging. In adult with MS, the kappa free light chain (KFLC) index has proven to be a reliable marker of intrathecal Ig synthesis.

Objective: To assess the diagnostic value of the KFLC index in a cohort of patients with paediatric-onset, inflammatory disorders of the CNS.

Methods: We included 73 patients and divided them into four groups: PedMS (n = 16), ODS (n = 17), encephalitis and/or inflammatory epilepsy (EE, n = 15), and controls without inflammatory CNS diseases (n = 25). The KFLC index was calculated and compared with the results of the oligoclonal bands determination.

Results: The KFLC index was higher in the PedMS group (median (interquartile range (IQR)): 150.9 (41.02-310.6)) than in the ODS (3.37 (2.22-8.11)), the EE (5.53 (2.31-25.81)) and the control group (3.41 (2.27-5.08)), respectively. The best KFLC index cut-off for differentiating between patients with PedMS and controls was 6.83 (sensitivity: 100%; specificity: 92%). A KFLC index over 93.77 indicated that the patient is very likely to have PedMS (sensitivity: 68%; specificity: 100%).

Conclusion: The KFLC index is a reliable tool for the diagnosis of MS in a paediatric population.

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卡帕游离轻链指数是儿科多发性硬化症的准确诊断生物标志物。

背景：多发性硬化症（MS）可能在 18 岁前发病。区分儿童多发性硬化症（PedMS）和其他脱髓鞘综合征（ODSs）具有挑战性。在成人多发性硬化症患者中，卡帕游离轻链（KFLC）指数已被证明是鞘内 Ig 合成的可靠标志物：目的：评估 KFLC 指数在一组儿科中枢神经系统炎症性疾病患者中的诊断价值：我们纳入了 73 名患者，并将其分为四组：PedMS（16 人）、ODS（17 人）、脑炎和/或炎症性癫痫（EE，15 人）以及无中枢神经系统炎症性疾病的对照组（25 人）。计算KFLC指数并与寡克隆带测定结果进行比较：结果：PedMS 组的 KFLC 指数较高（中位数（四分位数间距（IQR）：150.9（41.02-3））：150.9（41.02-310.6））分别高于 ODS 组（3.37（2.22-8.11））、EE 组（5.53（2.31-25.81））和对照组（3.41（2.27-5.08））。区分 PedMS 患者和对照组的最佳 KFLC 指数临界值为 6.83（灵敏度：100%；特异性：92%）。KFLC指数超过93.77表明患者极有可能患有PedMS（敏感性：68%；特异性：100%）：KFLC指数是诊断儿童多发性硬化症的可靠工具。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Multiple Sclerosis Journal 医学-临床神经学

CiteScore

10.90

自引率

6.90%

发文量

186

审稿时长

3-8 weeks

期刊介绍： Multiple Sclerosis Journal is a peer-reviewed international journal that focuses on all aspects of multiple sclerosis, neuromyelitis optica and other related autoimmune diseases of the central nervous system. The journal for your research in the following areas: * __Biologic basis:__ pathology, myelin biology, pathophysiology of the blood/brain barrier, axo-glial pathobiology, remyelination, virology and microbiome, immunology, proteomics * __Epidemology and genetics:__ genetics epigenetics, epidemiology * __Clinical and Neuroimaging:__ clinical neurology, biomarkers, neuroimaging and clinical outcome measures * __Therapeutics and rehabilitation:__ therapeutics, rehabilitation, psychology, neuroplasticity, neuroprotection, and systematic management Print ISSN: 1352-4585