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Oligoclonal Bands in CSF

Since cerebrospinal fluid (CSF) is an ultrafiltrate of plasma, it has much lower concentrations of the highest molecular weight proteins such as IgG, IgA and IgM. Elevated CSF IgG levels can either be the result of diffusion of plasma IgG across an altered blood brain barrier or intrathecal synthesis. Patients with multiple sclerosis and other demyelinating disorders often have elevated CSF IgG concentrations due to intrathecal synthesis. One of the best methods to detect intrathecal IgG synthesis has been to examine CSF for the presence of oligoclonal bands (OCB) after separation of proteins by electrophoresis. IgG in normal CSF migrates as a faint diffuse zone, but in demyelinating diseases, IgG migrates as discrete oligoclonal bands.

During the summer of 2003, the FDA approved a new method for the detection of oligoclonal bands that uses isoelectric focusing plus immunofixation (IEF) instead of electrophoresis. The Consortium of Multiple Sclerosis Centers has endorsed IEF

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