Two types of specimen were submitted:
1) CSF = cerebral spinal fluid
2) serum = blood minus the cells and clotting factors
Only three of the results fall outside the given reference ranges.
PROTEIN, CSF 69.9 Range (15 - 45)
ALBUMIN, CSF 32.7 Range (<=27.0)
IGG SERUM 750 Range (767 – 1590)
None of them seem way out of range but in general the CSF protein level might increase from things like bleeding, nerve inflammation, or injury. There are many possibilities but with normal ratios these reports aren't supportive of a MS diagnosis.
FYI - Albumin and the antibodies that produce O-bands are both proteins.
The part of your result that reports O-bands is not significant for a MS diagnosis because the 2 bands that appear in the CSF also appear in the serum.
According to our forum Health Page on the subject:
“If all the bands in the CSF gel also appear in the serum, this means that the source of the inflammation is out in the body and the antibodies leaked over into the spinal fluid. This will appear as a ‘Negative’ result on the LP report and is not consistent with Multiple Sclerosis.”
Thank you for the info. And please do not think that I am denying any other possible diagnosis. My PCP is an Internal Specialist and I do trust his diagnosis. I am praying that he is wrong and that what I have is curable or at least not crippling. I am having a hard time finding anything that says that all of my test results are not a road map to MS. And trust me, I have been looking. I went back and read my results from the LP. The test result actually states "The oligoclonal band assay detected 3 or less IgG bands in the CSF, which are not present in the serum". Everything that I read about banding says that more than 95% of patients with multiple sclerosis have CSF banding of IgG class not detectable in serum, thereby providing powerful evidence for the diagnosis of MS.
The two most commonly used diagnostic laboratory tests for multiple sclerosis are CSF index and oligoclonal banding. The CSF index is the CSF IgG to CSF albumin ratio compared to the serum IgG to serum albumin ratio. The CSF index is therefore an indicator of the relative amount of CSF IgG compared to serum and any increase in the index is a reflection of IgG production in the central nervous system. Oligoclonal banding in CSF is slightly more sensitive (85%) than the CSF index. The use of CSF index plus oligoclonal banding has been reported to increase the sensitivity to over 90%.
Cerebrospinal fluid IgG index is positive (elevated) in approximately 80% of patients with multiple sclerosis.
This statement does make it difficult to understand the results as you reported them initially. I must say though, the statement says "3 or less" IgG bands were detected and that remains true even if the number detected is zero.
Is there any chance your samples were processed through the Mayo Health system? I only ask because the standard at Mayo calls for four unique o-bands to indicate MS. Most other places believe two unique bands are sufficient. Not judging anything here - the quote you posted from your report just sounds like the type of wording Mayo might use.
My understanding is that the CSF index was the standard before o-band reporting became common and can still offer valuable information but is less specific. Here too, yours is reported to be in the normal reference range.
I imagine you thank God regularly for your internist. Many PCPs, GPs and internists have championed members of this community, seeing us through to a final diagnosis - whatever it ended up being. I likely would have given up myself without the support of my family physician.
I hope your primary physician or the consulting neuro will give you a more complete explanation of the LP report. You deserve to understand things fully as the diagnostic process proceeds. Hopefully you’ll then share what you learn with us here. We’re all in a constant state of growing our knowledge.
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