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3191241 tn?1345032381

CSF results. MS?

I am in the process of getting some of my results back from my lumbar puncture to test for MS.

Any help would be greatly appreciated in understanding these and which ones i should be worried about.

My one question is, ive seen the standard ranges vary from person to person, how does this work, and how do i know the standard range is correct??

IGG INDEX, CSF + BLOOD

IgG (serum) my value: 1200     standard: 694 - 1618   mg/dL
Albumin (serum) my value: 4.6     standard: 3.7 - 5.1    g/dL
CSF IgG my value: 2.5       standard:  0.8 - 7.7   mg/dL
CSF Albumin my value: 18.4   standard:  8.0 - 42.0    mg/dL
CSF IgG Index  my value: 0.52   standard:  <0.66
CSF IgG Synthesis Rate  my value: -2.9  standard:  -9.9 - 3.3  mg/24h

CSF Protein my value: 47  standard:  15 - 45 mg/dL     H


GLUCOSE, CSF - LAB
CSF Glucose my value: 56  mg/dL
-Reference Range: concentration of Glucose in CSF is about
60-75% of that in corresponding plasma.

CSF Angiotensin-1-Conv Enz   my value: 10     standard: <=15  U/L

CSF VDRL   my value: NONR      standard:  Nonreactive


CSF Lyme Antibody
SEE BELOW

LYME DISEASE AB [IgG],IFA <1:4
B BURGDORFERI IgM, IFA <1:1
INTERPRETATION
ANTIBODY NOT DETECTED
REFERENCE RANGES: IgG <1:4
IgM <1:1
Diagnosis of infections of the central nervous
system can be done by demonstrating the presence
of intrathecally-produced specific antibody.
However, interpreting results is complicated by
low antibody levels found in CSF, passive
transfer of antibody from blood, and contamination via
bloody taps. The interpretation of CSF results
must consider CSF-serum antibody ratios to the
infectious agent. However, demonstration of class
specific antibody IgM in CSF may be diagnostic.
The intrathecal synthesis of Lyme disease
antibody is most accurately measured by
performing the Lyme Disease Antibody Index
for CNS Infection.


these are all ive gotten so far other then me WBC count which is 3 out of 3-5.

any help would be great! thanks for your time and god bless!
41 Responses
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5597711 tn?1370821338
Would love it it some of you would look at my post -

In MS Limbo - wanting thoughts/opinions

I have many of my test results there and would love some advice
Helpful - 0
5597711 tn?1370821338
Don't forget the Thyroid (maybe you did and I didn't see it)
All the same symptoms an most Doctors won't recognize the "new" norms in testing.
I had an MRI that showed lesions some typical and some atypical of MS, then LP with elevated protein and 2 O bands (none in serum) and many symptoms … But Neuro wants to wait and do a follow up MRI in five months
In the mean time my reg. MD tested my thyroid and it was 5.11 TSH so she ordered FT3 and FT4. All fell within the old range but my doctor said the old norms are a bunch of bs basically and put me on Armour.
What a change for me!!! I still have other symptoms but I don't get up everyday dragging and feel as though I was hit by a truck.
Helpful - 0
1831849 tn?1383228392
My CSF RBC was 1, with a reference range of 0-10 Cells/mcL.

From the National Institutes of Health web site:

"Red blood cells in the CSF sample may be a sign of bleeding into the spinal fluid or the result of a traumatic lumbar puncture."

The key is the o-bands. They found 6 in your CSF. If you have 6 in your serum (blood sample) it would point away from MS. If you do not have o-bands in your serum it would point towards MS.

Remember that there is no single smoking gun that will say It's MS!

Kyle
Helpful - 0
Avatar universal
hello, It has" 6 " under bands. but all the way to the right side of the page it has a % sign. If you are saying no %, then I know now it doesn't belong. another thing i forgot to mention was my RBC was 220. When i research this, my understanding is there should be no RBC in CSF. but it did state trauma to spinal cord. would having the LP do this to RBC?

my cell count-CSF
monocytes 14
lymphocytes 50
bands 6
neutrophils 30
WBC 2
RBC 220
protein 42
glucose 56
all CSF and no serum result yet
do you know if any of these numbers mean anything else?
thanks a million
Helpful - 0
1831849 tn?1383228392
" I do not care for this doctor and as soon as I get my final results of LP. I will be switching."

I did the exact same thing :-)

RE: O-bands I have never seen them expressed as a percentage. Mostly I have seen them expressed as a number. For example I have > 5 o-bands in my CSF not found in my serum. Does your lab report express a number?
Helpful - 0
Avatar universal
hello everyone, I just stumbled on this MS chat while trying to find information on whats is the standard range for O bands. At this time I haven't found anything yet. Does anyone know the answer?

I have read the chats from Oct 3 to current. there is a chart listed @ www.aafp.org for CSF standard. It even has a list with diseases(MS). Type in Cerebrospinal Fluid analysis. you'll find it.

To Samantha, It upset me to hear your LP was painful. I had one done last week. I had no pain. My test was done by a radiologist at the hospital. If anyone has to have this done. I recommend a radiologist. He was wonderful and well experience because of where he's employed.

To give a background about myself, i am 39 years old and have had symptoms for about 5 years now. In the past 9 months, all of my symptoms have gotten worse and vertigo has set in. In the beginning doctors kept telling me,I was too young to feel this way. Sad part is, I believed them at first. Last year I finally got to a rheumo, she DX me with fibro but strongly believe this was my secondary problem and ran a blood test. all negative. (so frustrating). Early 2012 is when the vertigo set in and the events lead me to a vestibular lab. results, failed 2 of 3 test, then MRI of  brain with and without contrast. came up abnormal. MRI suggests Dawson Fingers(MS). Now I'm being seen by a Neuro. I had to take the first available appt because I had an incident of lost vision in right eye. I do not care for this doctor and as soon as I get my final results of LP. I will be switching. So today I got some results of LP( which is available to me online). I am trying to get answers on the O bands. I have those results. I have 6% bands. Any input would be great.

I am very frustrated  because my primary md read results from brain MRI, told me I had MS. took me out of work, not aloud to drive. on SSD which I'm so thankful I have this benefit. When I went to Neuro I was expected to start some form of treatment but instead, off to the races with more and more test. By the end of this month, I've had @12 test done in the last 2.5 months.

I have been told, that joint pain can be MS eventhough it is not listed as a symptom. I have read lupus, sjogren. All my spmptoms correspond with MS. I think I am so close to having a 99% answer, I cant stand it. I work with a young lady who has MS. She gave me her advice. If you don't like your doctor, find another one. BE PROACTIVE in finding all information.
My advice, DON"T let a doctor tell you what or how you should feel. It is your body. You know it the best, not them.  Thank you community for listening...lol or reading. God bless you all. Christine
Helpful - 0
3191241 tn?1345032381
diagnosed with fibromyalgia yesterday. i am still getting the western blot test done to test again for lyme, and then to see the MS specialist in december to make sure i dont have MS.
Helpful - 0
Avatar universal
yes you can have both
Helpful - 0
3191241 tn?1345032381
oh boy. i didnt know they did that test to see where you feel the pokes! ahh

I am still wondering if i should go to the MS specialists even if i do get a diagnosis of fibro next week. i could still have MS right? should i still meet with the specialist for MS in december?
Helpful - 0
Avatar universal
well there are diagnostic tests for fibro, the great "poke" you in 18-20 places and see how many times you yell "ouch that hurts"
be sure and google tests for fibro, its very interesting
Helpful - 0
Avatar universal
Sounds like you are working all possibilities, which I think is wise. It takes too long to do work ups for one of these conditions at a time and you could decline while waiting.

When I suspected Lyme, I still went through the MS work up because multiple doctors recommended it. It was helpful to have an MS specialist say that I didn't have it so we could put it to rest.

That is great that your doc agreed to the IgeneX test. It should be helpful. False negatives are possible there, but less common. If you have been sick less than a year, odds are good it will show signs of Lyme if you have it.

I have the hesitancy when urinating, too.  You can see why it can get so tricky to differentiate between these conditions. While the underlying cause is very different, the outward presentation can be very similar.  Fibro should be the diagnosis of last resort, after eliminating everything else, as there are no tests to confirm it.

If you do have Lyme, heat can help ease pain. (Many pain killers don't help with Lyme pain, but different people respond differently.). I used a heating pad for my abdominal pain.  Just be careful not to lie down on the heating pad as it can burn you without you even realizing it.

I hope you get an answer soon!
Helpful - 0
Avatar universal
you are really sounding like fibro, and surely some baclofen and neurontin will make you feel better.  check with your neuro or rheumy about those.

good luck and keep us posted, we all learn from each other

Sarah
Helpful - 0
3191241 tn?1345032381
wow thanks Laura. yes, you sound just like me. obsessed with getting somewhere in this fight and trying to succeed at it to get answers.

im definitely ready to go to the rheumatologist and see what they say, also i got my family doctor to order the Western Blot Lyme test from CA, so that should be in soon and i can go get that done.

ill update when i do go back to the doctor soon/ next week.

yesterday i had another severe pain feeling that ran down the back of my neck and into my back/ shoulder blade. SOOO absolutely painful, i couldnt even sit at my desk at work without wanting to cry. yesterday evening and into sleep that night i wore a therma care heat pad that is used to wrap around yoru back. i wrapped it over my shoulder around my neck and under my left arm to try to get the heat to hit it. it doesnt hurt as bad today, but it is still very painful. :/

thanks guys for all your input
Helpful - 0
1710955 tn?1309446473
Sounds like fibro to me, however there is no f
diagnostic test to prove you have it.  There are certain points on your body, either 16 or 18, if you've had pain in 11 (I think) of those points for 3 mos or longer they can dx you.

Personally, I wouldn't waste my time or the ms specialists time since there are no lesions on your brain or spine and the lp was negative.  I think it's more important to have this lyme test first, and all of the other blood tests your pcp should have ran before sending you to a neuro.

Back to a fibro dx...fibro has many of the same sx as MS. Horrible fatigue, muscle spasms, memory problems, sleeping problems, depression.  Although I'm unaware of any urinary problems related to fibro, there could be another explanation other than MS.

I admire your commitment to getting yourself a dx.  I am the same.  I get very focused and determined to get answers...almost to the point where I'm obsessed.  That being said, I wouldn't throw all your eggs in the MS basket.  Like I said earlier, I think you should go back to your pcp and have blood work done.  Your lyme test, vitamin deficiencies, an ANA test, basic metabolic panel for your glucose level, etc.  These should have been done from the very beginning, and will help with a dx or rule another out.

I would still see the rheumy, because of the fibro.  The rheumy can also run tests to check for RA, lupus, sjogrens, and other rheumatic diseases.

And of course, just because you might get one dx doesn't mean you don't have something else going on as well.  Let's say you do get a fibro dx, and 6 mos latter you experience a bout of neuropathic pain.  Fibro causes muscular pain but not neuropathic so there would have to be something else causing it other than the fibro.

**sighs** So much what ifs, and it could be this or that.  I'm over tired and rambling.  My apologizes.

Just go to your pcp and rheumy appts and let us know how it goes!

Good luck!
Laura
Helpful - 0
3191241 tn?1345032381
Correct, no lesions at all. sorry for the confusion guys.

my family doctor just ordered me the western blob lyme disease test to rule that out. and i see my rheumatologist on oct 26th to see if its fibromyalgia. im still leaning towards MS, but these other things are possinilities too. i guess we'll see!

today i wont up with a very bad muscle ache from my lower neck to the back of my sholder going towards my mid back. i definitely didnt sleep wrong, and i always sleep on my back. I'm so confused as to how i get these really bad muscle pains. i can hardly move my neck at all b/c it shoots fown my shoulder in the back and thoracis area. ugh :'( i cant take too much time off work, so i came in today, and now im suffering. even vicodin doesnt do anything!
Helpful - 0
1831849 tn?1383228392
Your mind may not be in the Lost & Found after all. This from a post in this thread...

"He said since the MRI showed no active lesions and the spinal tap was ok other then high protein that i can't get the Evoked Potential test done. Is this true that he "can't" send me to get it done, or can he still send me if i beg? "
Helpful - 0
352007 tn?1372857881
Agreed Kyle that particular point needs clarification from her Neuro in regard to "no lesions" versus "no active lesions".

However, in one of her previous posts she states "no lesions on the MRI" and from somewhere I thought I "no active lesions". (Am I losing my mind? I can't even find that part!)    (Don't mind me, I just may be  losing my mind).

Lisa
Helpful - 0
1831849 tn?1383228392
Information gathering is the key to finding a diagnosis. Now you have more information.

It's important to clear up a point raised by LisaJF. You said your doctor said your MRI did not show any "active lesions". He needs to clarify what he means. Did your MRI show any inactive lesions? Did they show no lesions at all?

If they showed no lesions at all, and your LP did not show any O-Bands, it might not be MS. If you have inactive lesions, the negative LP doesn't really count for much these days.

Kyle
Helpful - 0
3191241 tn?1345032381
the o-band test came back the day OF my follow up, he didnt sign off on it util then b/c he was on vacation.

here are those results:

Oligoclonal Bands, CSF   SEE BELOW


No bands Reference Range: No bands
No oligoclonal bands were identified in this
patient's CSF when compared to their
corresponding serum sample. The clinical
significance of a numerical band
count, determined by Isoelectric Focusing, has
not been definitively defined. The data should be
interpreted in conjunction with all pertinent
clinical and laboratory data for this patient


doesnt look like anything here, but he still thinks i have MS. so we will see! im so glad to have gotten to my next step. i called my family doctor and requested to be specifically tested for Lyme b/c thats a big possibility also. waiting to hear back from them.

im sorry to hear you deal with the hesitation when urinating often, kyle. it was def scarey! i was lucky enough to only experience it for one week.

i see a rheumatologist oct 26th. he said he wanted me to be checked for fibromyalgia just incase.
Helpful - 0
198419 tn?1360242356
Hi there,

Regular neuros recommend MS specialists for a variety of reasons, i.e., when they cannot be certain it's MS, or just the opposite when MS is dx'd, but the case is difficult, or for a 2nd opinion to their dx. Reasons surely vary from case to case.

I agree w/Sarahsmom that it may be suspected, but also that it's not a definite either way. Some MS specialists have more experiences w/MS patients than regular neuros. While some, "only" see MS patients, etc..

You are on to your next round lady. Good luck at your next appt. and I hope you know something either way soon.

Helpful - 0
1831849 tn?1383228392
" hesitation when urinating"

This is one of my ongoing symptoms. It is one of my symptoms that has been around for a while. I never connected it to other symptoms and the urologists I saw never mentioned MS. Turns out it is MS related, as there is nothing wrong with my plumbing.

I take .8mg Flomax every day. It's a drug designed to deal with enlarged prostates. There is nothing wrong with my prostate (and you don't even have one!) but the med definitely helps.

Kyle
Helpful - 0
Avatar universal
So did he mention any "O" bands when he called?  That would tell you something.  He must suspect MS if he's sending you to an MS specialist.
Keep us posted and good luck
Helpful - 0
3191241 tn?1345032381
had my follow up appt from my spinal tap on tuesday.

he is sending me to an MS specialist and a rheumatologist for fibromyalgia. He doesnt know which one, but thinks its one of them. He said my previous issue with hesitation when urinating is what bothered him b/c that kind of thing doesnt just happen.

i see the rheumatologist on oct 26th this month and i'm still waiting on appt's for the MS specialist.

i didnt think they sent you to an MS specialist unless they really believe you have it?

Glad I'm getting somewhere!

Helpful - 0
3191241 tn?1345032381
Thanks, i will def check that out!
Helpful - 0
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