LP lab report-couple Q's

[mindwhirl]

All my values were middle to low in the normal range.  I'm confused on the O-band result, though.  It does not say "negative" or "positive".  It explains identical band patterns were seen in CSF and serum. The interp of the bands criteria for positivity states that 4 or more CSF-specific have been shown to be most consistent with MS "using our method".

So does this mean none of the bands are unique to the CSF, or that there is just less than 4? It is LabCorp if that helps anyone.

It also states that the matching bands could represent an immune response to inflammatory process outside the CNS.  Is that something a doc should evaluate?

Apparently the doc only ordered an MS panel. Is the LP the test they use for Lyme?

Since I now have a negative LP, and it is HIGHLY unlikely to have MS if you have a negative LP and a negative MRI, does my MRI count as negative?  A 6 mm lesion and a since disappeared 2 mm, with nothing new in over a year?

[mindwhirl]

Thank you for responding-sorry about the pain :(

Protein, IgG, and albumin tests were all within normal range.  It doesn't look like any of the other things were tested, nor will they ever be.  I will never willingly go through that again!

[Quixotic1]

Wait!  There's More!!

Your MRI is not normal.  You have a lesion.  That increases your chances enormously of having MS if you have a history of relapsing symptoms.  The fact that it hasn't changed means very little.  It doesn't matter that we don't know the cause of the lesion.  In the face of neurological symptoms we at least have to entertain the possibility that the lesion is causing some of the symptoms.

An LP should be sent for the following at minimum.(for MS)

Cell counts
Protein
Glucose
quick tests for common meningitis bacteria
Calculation of IgG Index (involves measuring the synthesis of antibodies (globulins) & albumin in the blood and CSF)
Cytology - Cultures (bacteria, fungal, TB, etc)
Oligoclonal Bands (often sent to outside labs)

Many docs will also order tests for Lyme - useful when it is positive)

So it sounds like he didn't look for Lyme Disease.

Quix - signing off.  pain.

[Quixotic1]

That report states that the "same" bands are seen in the CSF as in the serum.  It's not just the "number" of bands, it's how many are in unique positions when they do the testing.  When they use the term "identical" they say that the CSF and serum results are the same.  (ie. not unique)

Take a look at this

http://www.medscape.com/content/2003/00/46/38/463864/463864_fig.html

Each band has it's own physical position on the test.  The serum can have bands, and the CSF can have bands.  If all the bands in the CSF appear ONLY on the CSF test then those are unique and would count as positive.  It's sort of like looking at the DNA results on CSI.  They match up bands in different positions.  (it's actually a similar test)

So, this would indeed be a negative test by all criteria, the normal which requires 2 or more and the Mayo Clinic which is trying to convince the world that 4 or more is what should be accepted as positive.

Better?  or is it still garbled.  You also might try reading:

http://www.medhelp.org/health_pages/Multiple-Sclerosis/Can-you-Diagnose-MS-with-an-LP-that-is-Negative-for-O-bands/show/142?cid=36


Quix

[mindwhirl]

I guess what I mean to say regarding the O-bands is are ALL the bands found in the CSF also in the serum and 0 are ONLY in the CSF, or do a # of bands match the blood but there might be 1-3 only in the CSF, so by their standards it's negative,[ but not by Quix's ;) ] and therefore not reported?

[jensequitur]

I think what that means is they found the same number of o-bands in the serum as in the CSF, which means a negative result.  

However a negative LP does not mean that you don't have MS.  Since your MRI showed evidence of lesion activity, then I think that would qualify.