title: Cerebrospinal fluid oligoclonal bands in childhood opsoclonus-myoclonus.
abstract: Oligoclonal bands in cerebrospinal fluid reflect local B-cell responses associated with various neuroinflammatory disorders. In opsoclonus-myoclonus syndrome, cerebrospinal fluid B-cell expansion was demonstrated, but no studies of oligoclonal bands are available. In a prospective case-control study of 132 children (103 with opsoclonus-myoclonus, 29 neurologic control subjects), cerebrospinal fluid oligoclonal bands, measured by isoelectric focusing with immunofixation, were observed in 35% with opsoclonus-myoclonus and none of the control subjects, with the highest frequency in severe cases (56%). In oligoclonal band-positive patients, the mean band number was 5 ± 3 S.D. (range, 2-10) and the total severity score was significantly higher than in band-negative patients, whereas the frequency of CD19(+) B cells, opsoclonus-myoclonus duration, neuroblastoma detection, and relapse history did not differ. The cerebrospinal fluid immunoglobulin G synthesis rate, immunoglobulin index, and Q albumin were normal. In 17 untreated children receiving adrenocorticotropic hormone, intravenous immunoglobulins, and rituximab, the number of oligoclonal band-positive decreased by 75%, and the mean band count fell by 80%. Oligoclonal band detection adds useful information to neuroimmunologic "staging" in opsoclonus-myoclonus. However, flow cytometry provides a more sensitive measure of B-cell infiltration. Cerebrospinal fluid oligoclonal bands warrant monitoring in long-term follow-up studies of disease-modifying drugs for opsoclonus-myoclonus.
authors: Division of Child and Adolescent Neurology, Department of Neurology, Southern Illinois University School of Medicine, Springfield, Illinois 62794-9643, USA. mpranzatelli@siumed.edu
authors: Michael R
authors: MR
authors: Pranzatelli
authors: Patricia R
authors: PR
authors: Slev
authors: Elizabeth D
authors: ED
authors: Tate
authors: Anna L
authors: AL
authors: Travelstead
authors: Jerry A
authors: JA
authors: Colliver
authors: Suja Anne
authors: SA
authors: Joseph
mesh_terms: D000293:Adolescent; D015703:Antigens, CD / Q000378:metabolism; D001402:B-Lymphocytes / Q000378:metabolism; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D007074:Immunoglobulin G / Q000134:cerebrospinal fluid; D007223:Infant; D008297:Male; D043025:Oligoclonal Bands / Q000134:cerebrospinal fluid*; D053578:Opsoclonus-Myoclonus Syndrome / Q000134:cerebrospinal fluid* / Q000473:pathology; D012189:Retrospective Studies
chemical_list: D015703:Antigens, CD; D007074:Immunoglobulin G; D043025:Oligoclonal Bands