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Lab Manual for UCSF Clinical Laboratories

Lab Manual for SFGH

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Item Value
Available Stat? No
Test code INDX
Performed by? Chemistry
Sendout? no
Price range $$$
In House Availability Twice a week
Principle Rate immunonephelometry.

Interpretation The CSF IgG index is increased in 85 - 90% of patients with clinically definite multiple sclerosis (10 - 15% false negatives). The administration of steroids may increase the proportion of false negative results.

The proportion of patients with possible multiple sclerosis who have an increased IgG index and are destined to develop clinically definite MS is unknown. The CSF IgG INDEX is not specific for MS, and can be increased in a wide variety of other conditions (CNS infections, Guillain-Barré syndrome, possible demyelinating diseases besides MS, etc.). The clinical utility of the CSF IgG INDEX is similar to that of the CSF Oligoclonal band test.

Normal range
CSF IgG up to 5.8 mg/dL up to 58 mg/L
CSF Albumin 7.8 - 40.5 mg/dL 78 - 405 mg/L
Serum IgG 605 - 1536 mg/dL 6.05 - 15.4 g/L
Serum Albumin 2916 - 5639 mg/dL 29.16 - 56.39 g/L

CSF IgG Index is a calculated value:
[CSF IgG / CSF Albumin] / [Serum IgG / Serum Albumin]

Normal values, CSF IgG Index:
0.23 - 0.64; adult
0.39 - 0.81; < 1.5 yrs
0.33 - 0.63; 1.5 - 18 yrs

Synonyms Cerebrospinal Fluid (CSF) Protein;CSF;
Stability Serum should be collected within 24 hours of CSF. CSF free of bacteria may be stored up to one week at 2-8°C.
Additional information Laboratory confirmation of a definite clinical diagnosis of multiple sclerosis.
References 1. Link H, Tibbling G: Principles of albumin and IgG analysis in neurological disorders: 2. Relation of the concentration of the proteins in serum and cerebrospinal fluid. Scnd J Clin Lab Invest, 37: 391-396, 1977.

2. Tibbling G, Link H and Ohman S: Principles of albumin and IgG analysis in neurological disorders: 1. Establishment of reference values. Scand J Clin Lab Invest, 37: 385-390, 1977.

3. Tietz, N.W. Textbook of Clinical Chemistry and Molecular Diagnosis, ed. 4. St. Louis, MO: Elsevier Saunders, 579-580; 2006.

4. Walsh MJ and Tourtellotte WW: The Cerebrospinal fluid in multiple sclerosis. In: Multiple Sclerosis: Pathology, Diagnosis and Management. JF Hallpike, LWM Adams and WW Tourtellotte (Eds.), Chapman and Hall, London, p. 275-358, 1983.

5. Whicher JT et al: Immunochemical Assays for Immunoglobulins (Review Article) Ann Clin Biochem 21: 78-91, 1984.
CPT coding 82784
Last Updated 10/4/2010 6:25:34 PM
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