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J Neuroimmunol. 2016 Nov 15;300:30-35. doi: 10.1016/j.jneuroim.2016.10.001. Epub 2016 Oct 5.

MRZH reaction increases sensitivity for intrathecal IgG synthesis in IgG Oligoclonal band negative Multiple Sclerosis patients.

Author information

1
Neuroimmunology Unit, University of Campinas, Campinas, Brazil; CATEM - Multiple Sclerosis Care Center, Santa Casa de São Paulo, São Paulo, Brazil. Electronic address: r.paterno@me.com.
2
Neuroimmunology Unit, University of Campinas, Campinas, Brazil; Department of Neurology, Brigham and Women's Hospital, Ann Romney Center for Neurologic Diseases, Harvard Medical School, Boston, USA. Electronic address: fvonglehnsilva@bwh.harvard.edu.
3
Neuroimmunology Unit, University of Campinas, Campinas, Brazil. Electronic address: moraesadr@yahoo.com.br.
4
Neuroimmunology Unit, University of Campinas, Campinas, Brazil. Electronic address: vi_boldrini@hotmail.com.
5
Department of Neurology, University of Campinas, Campinas, Brazil. Electronic address: alfredodamasceno@hotmail.com.
6
Neuroimmunology Unit, University of Campinas, Campinas, Brazil. Electronic address: mdandrade43@gmail.com.
7
Neuroimmunology Unit, University of Campinas, Campinas, Brazil. Electronic address: allinydionete@yahoo.com.br.
8
Neuroimmunology Unit, University of Campinas, Campinas, Brazil. Electronic address: cristianecasanova@neurolife.com.br.
9
CATEM - Multiple Sclerosis Care Center, Santa Casa de São Paulo, São Paulo, Brazil. Electronic address: charlespt@einstein.br.
10
Department of Neurology, University of Campinas, Campinas, Brazil. Electronic address: damascen@unicamp.br.
11
Neuroimmunology Unit, University of Campinas, Campinas, Brazil. Electronic address: leonilda@unicamp.br.
12
Neuroimmunology Unit, University of Campinas, Campinas, Brazil; Department of Neurology, University of Campinas, Campinas, Brazil. Electronic address: carlosotavio@neurolife.com.br.

Abstract

Given the low detection rates of CSF IgG-Oligoclonal bands (IgG-OCB) in non-European Multiple Sclerosis (MS) patients and higher specificity of the MRZH-reaction, we evaluated whether associating MRZH-reaction to CSF IgG-OCB detection improved investigation of suspected MS. Paired CSF and sera were analyzed for IgG-OCB and polyspecific viral antibodies. IgG-OCB were detected in 72% of MS patients and an MRZH-reaction in 67%. Combining IgG-OCB and MRZH raised detection of IgG abnormalities to 97% of studied MS patients. Detection of IgG-OCB and/or ≥2 MRZH antibodies showed sensitivity of 88% and specificity of 92% for MS, versus 72% and 96% for IgG-OCB alone.

KEYWORDS:

Brazil; Cerebrospinal Fluid; Intrathecal synthesis; Multiple Sclerosis; Oligoclonal bands; Polyspecific antibodies

PMID:
27806873
DOI:
10.1016/j.jneuroim.2016.10.001
[Indexed for MEDLINE]

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