CSF - IgG Index!!!!!!!???????????

Is it conceivable that my CSF test result would not include a IgG Index?

And, my brilliant N3 neglected to mention that my CSF protein was elevated in my september LP.

It was 61 in 2001 when this all started and 73 now.

Does anyone know if there are age-adjusted CSF protein ranges for men?

Thanks!

Richard
OperaMBA

[Quixotic1]

The protein level is very non-specific with regard to MS.  It is most often normal in MS, if not, then is just mildly elevated.  61 and 73 fall into the mildly elevated range.  No, there is no age-adjustment for men or women.  the only age-adjustment I know of is for newborns.

I would certainly hope that when an LP is done for the purpose of looking for MS, that both an IgG index and assay for O-Bands would be done.  Either one of those can count as a "positive" toward MS.

The IgG index is a calculated value made up of the IgG level and the albumin level which make up the IgG Synthesis Rate.  These are determined for both the CSF and the blood - then the IgG Index is calculated.

Quix

[OperaMBA]

I had two o bands in the blood serum and two in the CSF, so no love there.

BUT, there is not an IgG index as far as I can see it anywhere on the "report", which is just a printout of the numbers entered into N3's computer system.

They didn't check the myelin specific thingy either...  I can't remember the acronym for it...

Checking for MS was supposed to be the purpose, but I've got a sneaking suspicion that N3 dropped the ball again.

Richard
O-MBA

[Quixotic1]

Well it isn't so much the "number" of O-Bands in the CSF and the Serum as it is the number of "unique" O-bands in the CSF.

So, in your case if the 2 O-Bands in the CSF were different from the 2 in the serum, they would count as a postive result.  From what I have seen, though, the lab makes this determination in reporting the result.  Does this make sense?

Quix

[OperaMBA]

Thanks Q.

Yeah it makes total sense to me.   This test must be something akin to a gas chromatigraph.

I am going to see if I can't get my hands on the actual reports...

Picard Out

[sllowe]

When did you get the last LP? I'm asking this because they keep your CSF and blood serum for a bit afterward. That length of time would depend on the lab.  I don't remember when you got it, but was hoping on the chance that you could pressure the Dr. to get further tests on it to include the Index.  If they took enough fluid they could do this.

[OperaMBA]

Sometime in September I think...

I'm calling the PCP right now, since he is the proactive one.

[SOONERMOM]

If you have  results that include your CSF and serum IgG and Albumin, your could plug the numbers in and calculate it out yourself.

The reference range on mine was <=0.85


http://www.clinlabnavigator.com/Tests/MultipleSclerosisPanel.html

[OperaMBA]

That is why I'm looking for the durn IgG numbers.

It would be just like these goofballs to not request something this obvious.

I think I stumbled across that very website last night.

[SOONERMOM]

So you don't even have the "lab report" itself?  I would call and ask for a copy to be faxed to me or copied and would pick it up.

You know, it's like they want you to do this test...and then afterwards there is minimal if no explanation of the results.

I just got a call saying that everything was normal.  Then months later I got copies and found that I had one O-band in Csf and none in the serum.  I get that it was technically a "negative" test and all....but I felt like I should have been told that.

[OperaMBA]

Okay, I just spoke with the nurse at N3's office.

The total IgG was not calculutated or considered.

Is it just me or is this totally bizarre when we are running it for the sole purpose of finding out about MS?

The nurse is going to see if the fluid is still viable so they can check it out.

Richard the Dejected

[SOONERMOM]

OMG!!!!

Unbelievable, I am so sorry!!  I hope they can still use the fluid that they have.

[OperaMBA]

I may have all of the reports that they have which are not summerized in a cogent manner.   They are simply a list of what test was performed.

I guess I shouldn't be surprised anymore by what is happening to me.

They have dropped the ball, or omitted things at every turn.

In your case, from all that I have read, most people with a separation of one usually resolve to more than one....

Richard the Dejected

[sllowe]

ok, HERE I GO AGAIN YELLING AT YOU...

Have the Drs office call the lab IMMEDIATELY!

All they have to do is tell the lab what they want done w/the serum and then fax them over a script!

I promise that if they still have the fluid, and enough of it, the lab will be more than happy to follow the order. The fluid will be in the fridge or freezer, etc.

K??

[sllowe]

Correction - the office is to tell the lab what they want run on your "CSF"

[OperaMBA]

Sir, yes Sir!

I called 'em already!

I told 'em if they didn't get on the stick that I was gonna send Doni by there with the axe handle!

[doni54]

You can bet I'm ready!!!!  Do you think they will laugh at me when I show up dragging my right leg.........mumbling incoherently.............etc., etc., etc.?

I'm here for you, my crazy dude friend!!!!

[OperaMBA]

Did you ever see "Sling Blade"?

You could just do your Billy Bob Thornton "uh huh", then whack 'em!

[doni54]

hee.............hee......................hee..................ha..................hee...................

You are just too funny, thanks........................I really needed to laugh today!!!!  I can always count on my buddy, Richard.

[OperaMBA]

Sorry to raineth on parade.

I just spoke with the lab and they no longer have my CSF, since it was longer than 4 weeks ago.

:-(

Simply Dejected

[Janette2836]

BUMMER!  :(   So sorry to hear that!   I would suggest getting another LP done but not with the risk of a spinal headache!

[doni54]

Dang it!!  Can you not catch a break!!! Unbelievable............no wonder you're angry.......dejected and down right fed up!!!!

I think you and I are going to have to rethink the artillery......axe handles just aren't going to do the job.

I'm here with you, buddy, you can blow off steam with me anytime!!!!

Here's some more (((((((((((((((((((((((((((((hugs))))))))))))))))))))))))))))))))))))

[Sarahsmom46]

I was reading your post with great interest at work, but since we are not allowed to do anything but view stuff I couldn't respond.

I am so glad to know that I'm not going crazy over the lack of information on my CSF panel.  That was a tough test to go through and to have such scant information really ticked me off.  Like you, I had 2 OCB in my blood and in the CSF, however, when you read the report interpretation, there was this caveat about there being 2 more OCBs not in the serum.  My lazy N1 told me that the IgG was normal, yet there was no IgG info on the report.  Also, they didn't do the myelin factor on me either.  What is up with that?  So, I am going to do what you did and ask about these specific tests.  Maybe the info was there somewhere but hidden, but doubt it.  

I wish you could have caught that CSF before it was no longer usable.  Perhaps this post will help anyone else out there having and LP who comes across this same issue.  I know I will remember it if I have to have another LP.  Thanks for posting this very interesting question.

Julie

[Deb61]

I have a worse one--my spinal fluid analysis from Mayo, was either lost or never sent.  Therefore, the O-band test was never done or lost.  

I don't need it now, because I already have an MS diagnosis.  But, it goes to show you that big-time mistakes do happen.