Oligoclonal band determination is mainly used to diagnose multiple sclerosis (MS), especially in patients with an ambiguous clinical picture and no characteristic imaging findings.
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Cerebrospinal fluid (CSF) proteins are typically produced by filtration from plasma across the blood-brain barrier. However, in some cases, immunoglobulins may be synthesized within the central nervous system.
IgG oligoclonal bands are a sensitive and specific marker for humoral immune responses within the CNS. These immune responses may be due to various pathological conditions, including infections, inflammation, and neoplasms. In some cases, oligoclonal IgG may be derived from serum, so serum and CSF should be examined in parallel.
There are two crucial clinical uses of the IgG oligoclonal band test:
- The diagnosis of multiple sclerosis where the presence of IgG oligoclonal bands in the CSF is one of the diagnostic criteria
- The investigation of patients with suspected central nervous system infections or inflammatory diseases of the central nervous system, such as viral encephalitis, bacterial meningitis, neurosyphilis, and systemic lupus erythematosus
The diagnosis of multiple sclerosis (MS) depends on clinical, imaging, and laboratory findings. Detecting elevated immunoglobulin concentrations in the cerebrospinal fluid (CSF) is a key laboratory diagnostic test in diagnosing MS.
70 to 80% of patients with multiple sclerosis have abnormal IgG indexes and oligoclonal bands in the CSF, and 90% have at least an abnormal IgG index or oligoclonal bands alone.
The presence of oligoclonal bands in the CSF in patients with multiple sclerosis does not correlate with the intensity and extent of demyelination. Oligoclonal bands may be present even when the level of IgG in the CSF is normal.
