Contribution of the detection of oligoclonal bands (OCB) in CSF for the confirmation of the diagnosis in multiple sclerosis (MS)

Introduction: The presence of oligoclonal bands of IgG in the CSF continues being the immunologic alteration of greater usefulness for the diagnosis of the multiple sclerosis. The method that has shown greater sensitivity for its detection is the isoelectric focalization in agarosa followed by inmunofix with specific IgG. Objective: The work was directed to the assimilation and validation of the method for the detection of OCB in our laboratory. Patients and methods. Samples of CSF and serum of patients with the diagnosis of defined EM were evaluated according to Posser's criteria and control subjects neurological and nonneurological, to determine the presence of OCB in these fluids. The method includes two stages: The assimilation of it and its validation (internal and external). The internal validation of the method contemplated the evaluation of sensitivity, specificity, precision and agreement tests. The external validation included an evaluation without information of control samples sent from a reference international laboratory for this system of diagnosis. Other analyses were directed to evaluate the contribution from this study's to the confirmation of the clinical and immunological diagnosis. Results: The prevalence of OCB obtained in EMCD group was of 78.13%. The results showed a sensitivity of method of 78; 13% and a global effectiveness of 89,02%, a predictive value of 92,58% positivity, in accordance with reported by other groups. The test showed in addition a sensible contribution to the confirmation of the immunological diagnosis (40%) and clinical (10.12%), confirming its potentiality like diagnosis support in EM. Conclusion: Our results enhance that the detection of OCB continues being an element of great value in the confirmation of clinical diagnose in neurological diseases and particularly way in EM.