Quantitative cerebrospinal fluid IgG measurements as a marker of disease activity in multiple sclerosis
J. T. Caroscio, S. Kochwa, H. Sacks, S. Makuku, J. A. Cohen and M. D. Yahr
The value of various parameters of reporting quantitative cerebrospinal
fluid (CSF) IgG levels to indicate disease activity in 34 patients with
clinically definite multiple sclerosis was examined. IgG alone correlated
significantly with increasing degree of disability and increasing number of
clinical central nervous system lesions. There was also a trend toward
higher mean IgG levels when the course was relapsing and progressive as
opposed to progressive or relapsing. For the IgG index, the relationships
were the inverse of that noted with IgG alone. IgG-albumin ratio and IgG
synthetic rate did not correlate significantly with course, number of CNS
lesions, or degree of disability, and there was no statistically
significant relationship between any parameter of reporting quantitative
CSF IgG and age, duration of disease, history of recent exacerbation, or
area of first involvement in the nervous system. We conclude that although
newer methods of reporting CSF IgG elevations in multiple sclerosis are
more sensitive and some of them, more specific, in confirming a diagnosis
than CSF IgG alone, this parameter remains the best marker of disease
activity in individual patients.
