help interpreting results from LP

[angela5674]

Quix or whoever else can help:

I received some of the results back from my LP.  Please help me interpret them.  Thanks in advance!

Multiple Sclerosis Panel
IgG Index 0.62  
Interp SEE NOTE  
IGG 573  
Alb, CSF 17  
Alb 4040  
IgG Synth Rate, CSF 0.0  
Oligo Bands, CSF Positive  
IgG, CSF 1.5  
IgG/Alb, CSF 0.09  
Myelin Basic Pro 1.89  
Alb Index 4.2

Coccidioides Ab, CSF
NONE DET < 1:2 0.1 0.1

Herpes Simplex, PCR
Cerebrospinal Fluid [CSF] See Note Not Detected

CSF Cell Count
Color Normal NORMAL  
Comments Cell count done on tube 2  
Appear Clear CLEAR  
RBC, CSF 26 0-1  
WBC, CSF 2 0-5

VDRL
NON REAC

Cryptococcus Antigen, Screen
Cerebrospinal Fluid [CSF] Negative

Protein, CSF
Total Prot, CSF Options
(mg/dL)
Normal Range
12-60
29

Glucose, CSF
Glu, CSF Options
(mg/dL)
Normal Range
40-70
55

These are the results posted thus far.  I don't go back to the neuro until 9/25, so I'm trying to understand all of these numbers in the meantime.  Again, thanks for any help I get!  Angela

[sllowe]

Hi Angela,
I'm not sure of what it all means, however, they may be concerned with the positive oligo bands and the protein, but your protein seemed within limits. As far as the others, I really don't know enough to comment. With positive for bands, it means that it makes a demyelating or inflammatory disease more likely, but that interp should be followed up with a comment about your blood serum, which they will look for banding in as well, and compare if it's present.  I believe they an confirm it's of CNS origin if it's in the CSF and not in the serum.

Sorry I can't be of much more help with this one, and I hope you are okay.  I'm glad you are going back to the Neuro real soon.

SL

[grannyhotwheels]

I'm sorry that I can't help you but be patient and I'm sure someone will be able to cipher all of this.  

Quix is under the weather, so everyone will have to be patient.

I'll be praying,
Carol

[sllowe]

    Sending some definitions your way. . . .hoping it provides enough key words that you can further your search for an interp while waiting for the appt.

SL

http://www.chronolab.com/content/view/357/110/

[Nanners123]

On your note it refers twice to "see note" Was there a note at the bottom of the report?

Be sure to tell us when you get the results.

Nancy

[sllowe]

Just bumping this back up, and backing up Nanners comments.  There should of been an interpretation with the "see note" on your copy of the reports. On another page possibly?
Hope you are well,
SL

[angela5674]

I noticed it said "See Note" too, but there was no note connected.  I got this info online, so the actual report goes to the neuro.  I guess I will just wait and get his interpretation.  Angela

[Quixotic1]

I looked over your LP results.   Without the "Note" and the lab's range of normal values, I can only give an educated guess.

Basically the only positive was the presence of oligoclonal bands, but it doesn't say whether these were distinct from any bands found in the sreum (blood).  The other things that are looked for in the CSF looking for MS are the IgG index, and the IgG Synthesis Rate.  According to the labs I checked, your IgG Index is normal and the sysntesis rate is normal.  Everyhting else is normal.

The IgG Index is looking for antibody production which is inside the brain/spinal fluid space.  When this antibody production is higher than it is in the peripheral blood, it means that some immune B celss are actively producing antibodies in the CSF.  This is usually only found in inflammatory diseases and infections.  Other tests are done to rule out infections so if the Index is elevated (yours is not, I  think) it is highly indicative of MS.

The oligoclonal bands in the CSF need to be ones that are not present also in the blood.  This indicates that they are being produced and staying IN the CSF.  They like to see two or more bands to help with the diagnosis.  But, even one is more indicative of MS.

So your LP is slightly suggestive of MS.

Quix

[angela5674]

So then, based on my MRI results (3 lesions on the brain and at least 1 on my spine), combined with my LP, will the neuro need to run more tests in order to confirm a dx?  Or do you think based on my symptoms, MRI and LP, that he will try to start tx?  I know I'm in the majority with this "waiting game" but it drives me nuts!  Thanks for your response!  Angela

[sllowe]

Hi Angela,
I'm not responding for Quix, just responding in general.  I was dx'd after 3 brain lesions and one within the midline, within the spinal cord, and positive CSF olig. banding.  All other diseases were ruled out 1st.

The bloodwork that was run will not confirm the dx, but will eliminate all the mimics and any other possible diseases.  I think your Dr. has already steered the testing toward your dx, and that yes, with all the results, he can make his dx.  

Mine made the dx, but wanted me to get a 2nd opinion.  I think it's good protocol w/MS, since it's primarily a clinical dx (i.e. there is not 1 test in particular that says for certain "you have MS)."

The waiting game is tough, as will be the dx.

Wishing you the best,
SL

[angela5674]

Thanks to everyone who responded!  I just got my regular blood work done today so I'm getting those results back slowly.  Maybe when they come back I will post them and someone who knows more than I do can compare the CSF with the regular.

[angela5674]

Just bumping this up near my blood test results.  If anyone could help me interpret any of this, it would be very helpful!  Thanks in advance!  Angela