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751951 tn?1406636463

LP, Lyme, & all that.

Okay, yesterday I mentioned that I'd requested the full reports after the neuro's office sent postcards informing me all is well.  No idea how much any of this means (that's why I come here, of course), but here's what I'm picking up out of the repoorts that came today.

Under the heading "Immunoglobulin G Index," it lists IgG, Quant, CSF, 1.8 mg/dL, limits 0.0 to 8.6.  Albumin, CSF, 56 mg/dL, limits 11 - 48 (flagged as high).  Immunoglobulin G, Qn, Serum, 367 mg/dL, limits 700 - 1600 (flagged as low).  Albumin, Serum, 4.7 g/dL, limits 3.5 - 5.5.  IgG/Alb Ratio, CSF, 0.03, limits 0.00 - 0.25.  CSF IgG Index 0.4, limits 0.0 - 0.7.

(Does being high in CSF albumin and/or low in serum IgG mean anything to anyone?)

Immunoglubulin G, Syn Rate, CSF, is listed as -1.9 mg/day, with limits of -9.9 to +3.3.  That item's footnoted with a caution about proper interpretation.

Oligoclonal banding testing performed using Isoelectric Focusing (IEF) and immunoblotting methodology, negative.

CSF glucose is nearing the upper end of normal range; glucose in serum is 50% over the upper limit.  (I had a maple walnut Danish and a large English Toffee cappuccino from Tim Horton's on the way there; had no idea they'd be checking my sugar!)

Protein, Total, CSF scored 38.3  mg/dL, limits are shown as 13.0 - 40.0.  Looks like I'm near the upper end of normal here.  What does protein in the CSF tell us, anything?

There's another page about the Lyme tests; it looks like they did Western Blot, but maybe two types of tests; I need to decipher all the abbreviations before I understand it all, but in any case, it was all negative.

Any of this translate to English for any of you?
9 Responses
572651 tn?1531002957
PD, I am horrible with lab results, that is why I use labtestsonline.org as my reference.  If the neuro hasn't flagged anything out of the ordinary, that is good news.  It is especially looking good that this might not be MS - having zero o-bands is very good, although we know it is still possible to have the MonSter and no o-bands.

Even though you mention some of these at the limits of normal, they are still within what is considered acceptable ranges.  


Wikipedia offers this breakdown on each of the things tested:

"Several substances found in cerebrospinal fluid are available for diagnostic measurement.

Measurement of chloride levels may aid in detecting the presence of tuberculous meningitis.

Glucose is usually present in the CSF; the level is usually about 60% that in the peripheral circulation. A fingerstick or venipuncture at the time of lumbar puncture may therefore be performed to assess peripheral glucose levels in order to determine a predicted CSF glucose value. Decreased glucose levels can indicate fungal, tuburculous or pyogenic infections; lymphomas; leukemia spreading to the meninges; meningoencephalitic mumps; or hypoglycemia. A glucose level of less than one third of blood glucose levels in association with low CSF lactate levels is typical in hereditary CSF glucose transporter deficiency also know as De Vivo disease.

Increased glucose levels in the fluid can indicate diabetes, although the 60% rule still applies.

Increased levels of glutamine are often involved with hepatic encephalopathies, Reye's syndrome, hepatic coma, cirrhosis and hypercapnia.

Increased levels of lactate can occur the presence of cancer of the CNS, multiple sclerosis, heritable mitochondrial disease, low blood pressure, low serum phosphorus, respiratory alkalosis, idiopathic seizures, traumatic brain injury, cerebral ischemia, brain abscess, hydrocephalus, hypocapnia or bacterial meningitis.

The enzyme lactate dehydrogenase can be measured to help distinguish meningitides of bacterial origin, which are often associated with high levels of the enzyme, from those of viral origin in which the enzyme is low or absent.

Changes in total protein content of cerebrospinal fluid can result from pathologically increased permeability of the blood-cerebrospinal fluid barrier, obstructions of CSF circulation, meningitis, neurosyphilis, brain abscesses, subarachnoid hemorrhage, polio, collagen disease or Guillain-Barré syndrome, leakage of CSF, increases in intracranial pressure or hyperthyroidism. Very high levels of protein may indicate tuberculous meningitis or spinal block.

IgG synthetic rate is calculated from measured IgG and total protein levels; it is elevated in immune disorders such as multiple sclerosis, transverse myelitis, and neuromyelitis optica of Devic.

Numerous antibody-mediated tests for CSF are available in some countries: these include rapid tests for antigens of common bacterial pathogens, treponemal titers for the diagnosis of neurosyphilis and Lyme disease, Coccidioides antibody, and others.

The India ink test is still used for detection of meningitis caused by Cryptococcus
neoformans, but the cryptococcal antigen (CrAg) test has a higher sensitivity.

CSF can be sent to the microbiology lab for various types of smears and cultures to diagnose infections.
Polymerase chain reaction (PCR) has been a great advance in the diagnosis of some types of meningitis. It has high sensitivity and specificity for many infections of the CNS, is fast, and can be done with small volumes of CSF. Even though testing is expensive, it saves cost of hospitalization"

Now we're back to that same old question - what the heck is wrong with you?   I'm sorry the lp appears to have yielded no answers.  



be well,
Lulu
Avatar universal
PastorDan, Did they mention levels of myelin?  I didn't have any Ogliconal bands however; my myelin was elevated in my LP.

I hope you are feeling well after your procedure.
195469 tn?1388326488
The Western Blot for Lyme disease is not enough.  I totally forget what the other test is, but let me take a guess the way it's spelled....maybe someone will correct me if I am wrong.  It's called Elisa testing.  It needs to be done in conjunction with Western Blot.  

When I was bitten by an infected tick last year, with the typical bull's eye rash, of course it was easy to diagnose Lyme disease.  I also brought in the tick, which they sent off to the lab.  That little bogger tested positive for Lyme disease.  They did a Western Blot and the other test too.  I was put on antibiotics, before all the testing came back positive, because I had the bull's eye rash.

It really is amazing how many symptoms of MS, are the same as with Lyme disease.  But Lyme has some distinct differences.

Make sure you had both blood tests done.  I wish I could help you with your spinal tap results.  I am really "duh" when it comes to those.

All the Best, Mr. Newylwed Man and your precious, "Mrs. Pastor Dan." (Nancy)
Heather  
751951 tn?1406636463
Many thanks, you two.  No mention of lactate or myelin in my report.  The only things highlighted were the albumin high in CSF, immunoglobulin G low in CSF, and glucose high in serum.

The protein level in the CSF, as I noted, was approaching the upper end of the normal range, as was the glucose in CSF. That last item was 42% of the serum level; I noticed the reference Laura Lu cited stated to expect 60%, but it didn't sound like that was an absolutely correct or critical level at all, just "usual."

Are either myelin or lactate proteins?  I'm sure I can look that up, but I am thinking they're not.  I'll go do some reading on these things, & let y'all know what I find.

Again, thanks a bunch.
Avatar universal
Well, I know you have got to be as frustrated as all get out to still not know what is causing your problems.  I certainly understand how frustrating it is to have health issues that no one can define.  I went more than 30 years knowing I had something terribly wrong before anyone could diagnose me as having MS.  When I was 18 years old I was told I had Ankylosing Spondylitis.  Well, that Dr. was totally wrong.  I do not have Ankylosing Spondylitis.  It's a shame it took me so long to find a Dr. who knew what was wrong.

Pastor Dan, do you have brisk reflexes?  I think this is what finally made the Dr.'s realize something was very wrong.

Meanwhile, we will all just continue to pray for God to reveal the source of your problem.  I wish their was a simple blood test that could be done to detect MS.  God knows your need and frustration.   With prayers.

I do want to congratulate you on your marriage.  I pray that you have many happy years together!  Blessings!
751951 tn?1406636463
Thank you, Deb.  Yes, I think that my knee reflexes are abnormally brisk, but the neurologists' notes made so far don't reflect my opinion.  That is a pretty telling sign as you note, but it's also one that is prone to subjectivity, i.e., brisk is in the eye of the beholder.  I suppose it's one easily faked, too.  So many of us limbolanders live in constant fear that we aren't being taken seriously.  I think, to tell you the truth, that I probably try, involuntarily, to suppress my reflex response when tested, but I probably don't succeed all that well.  I'll try to remember to discuss it with the neuro next time we speak.

Blessings to you & yours, as well.
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