Journal
AMERICAN JOURNAL OF CLINICAL PATHOLOGY
Volume 138, Issue 2, Pages 262-272Publisher
OXFORD UNIV PRESS INC
DOI: 10.1309/AJCPCYCH96QYPHJM
Keywords
Myelin basic protein; Multiple sclerosis; Oligoclonal bands; IgG index; CSF analysis; Test utilization; Sensitivity and specificity; Biomarkers
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Diagnosis of multiple sclerosis (MS) is facilitated by analyzing biochemical properties of cerebrospinal fluid (CSF). Oligoclonal bands (OCBs) and immunoglobulin G (IgG) index are well-established markers fir evaluating patients suspected of having MS. Myelin basic protein (MBP) is also ordered frequently, but its usefulness remains questionable. OCB, IgG index, and MBP were measured in 16,690 consecutive CSF samples. Samples were divided into 2 groups based on MS status known (n = 71) or unknown (n = 16, 118). Medical charts of the MS status known group were reviewed to determine their MS status. OCBs have a stronger association to IgG index results than does MBP. Importantly, MBP does not add a statistically significant increase in diagnostic sensitivity or specificity when used in combination with OCB and/or IgG index. The data indicate that MBP is an unnecessary and overused test.
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