title: High sensitivity and specificity of elevated cerebrospinal fluid kappa free light chains in suspected multiple sclerosis.
abstract: Cerebrospinal fluid (CSF) analysis is routinely used in the diagnostic work-up of multiple sclerosis (MS), by detecting CSF-specific oligoclonal bands (OCB). More recently, several studies have reported CSF free light chains (FLC) as an alternative. We show that absolute CSF κFLC concentrations were highly sensitive - more than OCB testing - and specific for clinically isolated syndrome, relapsing remitting and primary progressive MS. Measurement of κFLC alone was sufficient. Our results suggest that CSF κFLC levels measured by nephelometry, if validated in a larger series, are a preferred test to OCB analysis in the diagnostic work-up of patients suspected of having MS.
authors.affiliation: Centre for Translational Inflammation Research, School of Immunity and Infection, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK.
authors.forename: G
authors.initials: G
authors.lastname: Hassan-Smith
authors.affiliation: Centre for Translational Inflammation Research, School of Immunity and Infection, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK.
authors.forename: L
authors.initials: L
authors.lastname: Durant
authors.affiliation: University Witten/Herdecke, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Tsentemeidou
authors.affiliation: The Binding Site Group Ltd, Birmingham, UK.
authors.forename: L K
authors.initials: LK
authors.lastname: Assi
authors.affiliation: The Binding Site Group Ltd, Birmingham, UK.
authors.forename: J M
authors.initials: JM
authors.lastname: Faint
authors.affiliation: Centre for Translational Inflammation Research, School of Immunity and Infection, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK; Neurology Department, University Hospital North Staffordshire, Stoke-on-Trent, UK.
authors.forename: S
authors.initials: S
authors.lastname: Kalra
authors.affiliation: Centre for Translational Inflammation Research, School of Immunity and Infection, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK; Department of Neurology, Dudley Group NHS Foundation Trust, Russells Hall Hospital, Dudley, UK.
authors.forename: M R
authors.initials: MR
authors.lastname: Douglas
authors.affiliation: Centre for Translational Inflammation Research, School of Immunity and Infection, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK. Electronic address: s.j.curnow@bham.ac.uk.
authors.forename: S J
authors.initials: SJ
authors.lastname: Curnow
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007145:Immunoglobulin kappa-Chains / Q000134:cerebrospinal fluid*; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000134:cerebrospinal fluid*; D009391:Nephelometry and Turbidimetry; D043025:Oligoclonal Bands / Q000134:cerebrospinal fluid*; D012680:Sensitivity and Specificity; D055815:Young Adult
chemical_list: D007145:Immunoglobulin kappa-Chains; D043025:Oligoclonal Bands
keywords: Free light chains; Multiple sclerosis; Oligoclonal bands