title: Multiple sclerosis: problems in the evaluation of intrathecal IgG synthesis.
abstract: We report two patients with multiple sclerosis which illustrate problems in the interpretation of the cerebrospinal fluid (CSF) protein studies used to confirm diagnosis. In one case a polyclonal increase in IgG synthesis, secondary to an aseptic meningitis, masked oligoclonal banding, which was confirmed on subsequent examination. In the second case, despite a normal quantitative intrathecal IgG synthesis rate, oligoclonal banding in the CSF confirmed abnormal intrathecal synthesis of IgG. These cases show the value of combining a quantitative index of intrathecal IgG synthesis with examination for oligoclonal banding and illustrate their interpretation.
authors.affiliation: Christchurch Hospital.
authors.forename: J M
authors.initials: JM
authors.lastname: Sheat
authors.forename: P M
authors.initials: PM
authors.lastname: George
authors.forename: I M
authors.initials: IM
authors.lastname: Donaldson
mesh_terms: D000328:Adult; D004587:Electrophoresis, Agar Gel; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000096:biosynthesis*; D009103:Multiple Sclerosis / Q000097:blood / Q000134:cerebrospinal fluid*
chemical_list: D007074:Immunoglobulin G