Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Weiss, B.
Evidenz für eine intrathekale Immunglobulinsynthese durch die Messung freier Leichtketten-kappa bei neurologischen Patienten mit einer isolierten Bande in der isoelektrischen Fokussierung
Humanmedizin; [ Diplomarbeit ] Medizinische Universität Graz; 2022. pp. 20
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- Autor*innen der Med Uni Graz:
- Betreuer*innen:
- Khalil Michael
- Pichler Alexander
- Altmetrics:
- Abstract:
- The determination of oligoclonal bands (OCB) in the cerebrospinal fluid (CSF) using isoelectric focusing (IEF) is the gold standard for detecting of intrathecal immunoglobulin synthesis. Controversy still exists regarding the significance of an isolated band in the CSF. A highly promising alternative method for the assessment of intrathecal inflammation is the quantification of kappa free light chains (k-FLC). Our aim was to evaluate the clinical significance of quantitative k-FLC in patients with an isolated band in the CSF. K-FLC was measured in 47 paired CSF and serum samples with a single band in IEF on a turbidimetric Optilite® using the Human Kappa Freelite Mx Kit (The Binding Site Group Ltd., Birmingham, UK). All participants underwent detailed clinical examination and laboratory evaluation. Based on the medical diagnosis we subclassified into 27× inflammatory neurological disorders (IND), 2× peripheral inflammatory neurological disorders (PIND), 9× non-inflammatory neurological disorders (NIND) and 9× symptomatic controls (SC). For a concentration of k-FLC to be considered positive, the discrimination limit (Qlim) was calculated using the Reibergram for k-FLC. k-FLC were below the lower measurement limit of the analyser (LML) in all SC and PIND, as well as in 8 out of 9 NIND and 11 IND. Only 1 NIND and 16 IND were above the LML, and of these, only 14 IND were above the Qlim. A neuroinflammatory nature of the diseases can be indicated in many cases by positive k-FLC in patients with an isolated band in IEF. The measurement of k-FLC can support the diagnosis of neurological diseases if they are included in the routine work-up.