title: CSF albumin and immunoglobulin analyses in childhood neurologic disorders.
abstract: OBJECTIVE
  To evaluate the utility of qualitative and quantitative analyses of CSF immunoglobulins as part of the diagnostic workup of CNS inflammatory conditions.
  
  
  METHODS
  One hundred eighty-nine children who underwent CSF investigation for their neurologic condition had CSF and serum testing to (1) qualitatively identify oligoclonal band (OCB) patterns and (2) quantitatively measure the immunoglobulin (Ig) G index and albumin quotient (QAlb). Case notes were retrospectively reviewed and patients were grouped according to whether their primary diagnosis was due to an inflammatory (n = 104) or noninflammatory (n = 85) etiology.
  
  
  RESULTS
  CSF-restricted OCBs were found in 20/104 (19%) of the inflammatory group compared with 4/85 (5%) of the noninflammatory group (p= 0.0036). Mirrored OCBs were found in 13/104 (12.5%) of the inflammatory group compared with 5/85 (6%) of the noninflammatory group (p = 0.14). IgG index and QAlb were significantly higher in patients with an inflammatory etiology. However, a raised IgG index (>0.85) and QAlb (>0.049) were seen in both groups, with QAlb abnormalities seen more frequently in the inflammatory group (p = 0.0028).
  
  
  CONCLUSIONS
  Both methods were informative in identifying inflammatory mechanisms. Abnormalities were more commonly, but not exclusively, seen in primary inflammatory conditions. The qualitative and quantitative evaluation collectively revealed additional positive results than when done in isolation.
authors.affiliation: Children's Neuroscience, Evelina London Children's Hospital at Guy's & St Thomas' NHS Trust, King's Health Partners AHSC, Lambeth Palace Road, London.
authors.forename: Yael
authors.initials: Y
authors.lastname: Hacohen
authors.affiliation: Children's Neuroscience, Evelina London Children's Hospital at Guy's & St Thomas' NHS Trust, King's Health Partners AHSC, Lambeth Palace Road, London.
authors.forename: Rahul
authors.initials: R
authors.lastname: Singh
authors.affiliation: Children's Neuroscience, Evelina London Children's Hospital at Guy's & St Thomas' NHS Trust, King's Health Partners AHSC, Lambeth Palace Road, London.
authors.forename: Vhari
authors.initials: V
authors.lastname: Forsyth
authors.affiliation: Children's Neuroscience, Evelina London Children's Hospital at Guy's & St Thomas' NHS Trust, King's Health Partners AHSC, Lambeth Palace Road, London.
authors.forename: Michael
authors.initials: M
authors.lastname: Absoud
authors.affiliation: Children's Neuroscience, Evelina London Children's Hospital at Guy's & St Thomas' NHS Trust, King's Health Partners AHSC, Lambeth Palace Road, London.
authors.forename: Ming
authors.initials: M
authors.lastname: Lim