Cerebrospinal fluid immunoglobulin quotients, kappa/lambda ratios, and viral antibody titres in neurological disease.
A description has been given of cerebrospinal fluid (CSF) immunoglobulins in 355 patients with demyelinating, infectious, neuropathic, and other neurological disorders. An increase in the CSF IgG/albumin quotient was observed in 19/36 (53%) cases of definite multiple sclerosis (MS), in 13/47 (28%) cases of probable or possible MS, in 6/9 (67%) cases of proven herpes simplex viral encephalitis (HSVE), in 3/4 (75%) cases of neurosyphilis, in 1/1 case of subacute sclerosing panencephalitis (SSPE), in 2/9 )22%) cases of other central nervous system infections, and in 2/12 (17%) cases of polyneuritis when compared with a group of 236 patients having other neurological disorders. In constrast, a relative increase in the CSF IgA of IgM was seen only in some of the patients with central nervous system infections. It was also found that the quotient CSF/serum IgG, expressed as a percentage of the CSF/serum albumin, was better in distinguishing patients with definite or suspected MS from those with other neurological disorders than the quotients IgG/albumin or IgG/total protein. The CSF K/lambda ratio and the CSF and serum complement-fixing antibody titre to measles and herpes simplex virus were measured in many of the patients. In general, abnormalities of these measurements were associated with raised IgG/albumin quotients. However, in eight patients with definite or suspected MS, a normal IgG/albumin quotient was found with abnormal CSF K/lambda ratios (6 cases) or abnormal CSF titres of measles antibody (7 cases). In addition, two patients, with HSVE had normal IgG/albumin ratios but detectable herpes antibody in the CSF. These findings suggest that the measurement of the relative concentration of CSF immunoglobulin in combination with the K/lambda ratio and antibody titre to various viruses may supplement each other in the endeavour to detect central nervous system immunglobulin sysnthesis in neurological diseases.
D000914:Antibodies, Viral / Q000134:cerebrospinal fluid*; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000134:cerebrospinal fluid; D007145:Immunoglobulin kappa-Chains / Q000134:cerebrospinal fluid; D007146:Immunoglobulin lambda-Chains / Q000134:cerebrospinal fluid; D007136:Immunoglobulins / Q000134:cerebrospinal fluid*; D008297:Male; D008459:Measles virus / Q000276:immunology; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000276:immunology; D009422:Nervous System Diseases / Q000134:cerebrospinal fluid / Q000276:immunology*; D012709:Serum Albumin / Q000134:cerebrospinal fluid; D018139:Simplexvirus / Q000276:immunology
D000914:Antibodies, Viral; D007074:Immunoglobulin G; D007145:Immunoglobulin kappa-Chains; D007146:Immunoglobulin lambda-Chains; D007136:Immunoglobulins; D012709:Serum Albumin