Tear analysis in clinically isolated syndrome as new multiple sclerosis criterion.
In clinically isolated syndrome (CIS), the detection of oligoclonal bands (OCBs) in cerebrospinal fluid (CSF) is critical for space dissemination validation when magnetic resonance imaging (MRI) diagnostic criteria are not fulfilled. However, lumbar puncture for CSF collection is considered relatively invasive. Previous studies have demonstrated applicability of OCB detection in tears to the diagnosis of multiple sclerosis (MS). The objective of the present study was to assess concordance between OCB detection in tears and in CSF. We have prospectively included patients with CIS and compared results of CSF and tear OCB detection by isoelectric focusing (IEF). Tears were collected using a Schirmer strip. We included 82 patients. For 69 of them, samples were analysable. OCBs were detected in CSF for 63.8% and in tears for 42% of patients. All patients with tear OCBs had CSF OCBs. We suggest that tear OCB detection may replace CSF OCB detection as a diagnostic tool in patients with CIS. This would circumvent the practice of invasive lumbar punctures currently used in MS diagnosis.
Calais
Gauthier
G
Groupe Hospitalier de l'Institut Catholique de Lille, Service de Neurologie, Lille, France. calais.gauthier@ghicl.net
Forzy
Gerard
G
Crinquette
Charlotte
C
Mackowiak
Alexandre
A
de Seze
Jerome
J
Blanc
Frederic
F
Lebrun
Christine
C
Heinzlef
Olivier
O
Clavelou
Pierre
P
Moreau
Thibault
T
Hennache
Bernadette
B
Zephir
Helene
H
Verier
Albert
A
Neuville
Véronique
V
Confavreux
Christian
C
Vermersch
Patrick
P
Hautecoeur
Patrick
P
D000328:Adult; D017668:Age of Onset; D004587:Electrophoresis, Agar Gel; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000032:analysis / Q000134:cerebrospinal fluid / Q000378:metabolism; D007525:Isoelectric Focusing; D008279:Magnetic Resonance Imaging; D008297:Male; D009103:Multiple Sclerosis / Q000134:cerebrospinal fluid / Q000175:diagnosis* / Q000378:metabolism; D043025:Oligoclonal Bands; D011446:Prospective Studies; D013666:Tears / Q000737:chemistry* / Q000276:immunology; D055815:Young Adult
D007074:Immunoglobulin G; D043025:Oligoclonal Bands