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Test ID: OLIG Oligoclonal Banding, Serum and Spinal Fluid

Reporting Name

Oligoclonal Banding

Useful For

Diagnosis of multiple sclerosis; especially useful in patients with equivocal clinical presentation and radiological findings

Clinical Information

The diagnosis of multiple sclerosis (MS) is dependent on clinical, radiological, and laboratory findings. The detection of increased intrathecal immunoglobulin (Ig) synthesis is the basis for current diagnostic laboratory tests for MS. These tests include the measurement of kappa free light chains in cerebrospinal fluid (CSF) and CSF oligoclonal band (OCB) detection. Abnormal CSF OCB patterns have been reported in 70% to 80% of MS patients. 

 

Increased intrathecal Ig synthesis may occur in other inflammatory CSF diseases and, therefore this assay is not specific for MS.

Interpretation

The oligoclonal band assay detected 2 or more unique IgG bands in the cerebrospinal fluid (CSF). This is a positive result.

 

CSF is used in the diagnosis of multiple sclerosis (MS) by identifying increased intrathecal IgG synthesis qualitatively (oligoclonal bands). The presence of 2 or more unique CSF oligoclonal bands was reintroduced as one of the diagnostic criteria for MS in the 2017 revised McDonald criteria. These findings, however, are not specific for MS as CSF-specific IgG synthesis may also be found in patients with other neurologic diseases including infectious, inflammatory, cerebrovascular, and paraneoplastic disorders. Clinical correlation recommended.

Profile Information

Test ID Reporting Name Available Separately Always Performed
OLIGS Serum Bands No Yes
OLIGC CSF Bands No Yes

Analytic Time

2 days

Day(s) and Time(s) Performed

Monday through Friday; 7 a.m.-12 p.m.

Clinical Reference

1. Andersson M, Alvarez-Cermeno J, Bernardi G, et al: Cerebrospinal fluid in the diagnosis of multiple sclerosis: a consensus report. J Neurol Neurosurg Psychiatry 1994;57:897-902

2. Fortini AS, Sanders EL, Weinshenker BG, Katzmann JA: Cerebrospinal fluid oligoclonal bands in the diagnosis of multiple sclerosis, isoelectric focusing with the IgG immunoblotting compared with high resolution agarose gel electrophoresis and cerebrospinal fluid IgG index. Am J Clin Pathol 2003:120:672-675

3. Thompson AJ, Banwell BL, Barkhof F, et al: Diagnosis of multiple sclerosis: 2017 revisions of the McDonald criteria. Lancet Neurol 2018 Feb;17(2):162-173

4. Gurtner KM, Shosha E, Bryant SC, et al: CSF free light chain identification of demyelinating disease: comparison with oligoclonal banding and other CSF indexes. Clin Chem Lab Med 2018;56:1071-1080

5. Saadeh R, Pittock S, Bryant S, et al: CSF kappa Free Light Chains as a Potential Quantitative Alternative to Oligoclonal Bands in Multiple Sclerosis. Neurology 2019 April 09, 2019;92

Method Name

Isoelectric Focusing (IEF) with IgG Immunoblot Detection

Specimen Type

CSF
Serum


Specimen Required


Both serum and spinal fluid are required. Spinal fluid must be obtained within 1 week of serum collection.

 

Specimen Type: Serum

Container/Tube:

Preferred: Red top

Acceptable: Serum gel

Specimen Volume: 0.5 mL

Collection Instructions: Label specimen as serum.

 

Specimen Type: Spinal fluid

Container/Tube: Sterile vial

Specimen Volume: 0.5 mL

Collection Instructions: Label specimen as spinal fluid.


Specimen Minimum Volume

Serum, Spinal Fluid: 0.4 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
CSF Refrigerated (preferred) 14 days
  Ambient  14 days
  Frozen  14 days
Serum Refrigerated (preferred) 14 days
  Ambient  14 days
  Frozen  14 days

Reference Values

CSF Olig Bands Interpretation: <2 bands

Test Classification

This test has been cleared, approved or is exempt by the U.S. Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.

CPT Code Information

83916 x 2

LOINC Code Information

Test ID Test Order Name Order LOINC Value
OLIG Oligoclonal Banding In Process

 

Result ID Test Result Name Result LOINC Value
8017 CSF Bands 56764-4
2783 Serum Bands 56974-9
23611 CSF Olig Bands Interpretation 49852-7
Mayo Clinic Laboratories | Neurology Catalog Additional Information:

mml-Behavioral, mml-Epilepsy, mml-Movement-Disorders, mml-Demyelinating-Diseases, mml-Neuroimmunology, mml-Neuromuscular, mml-Autonomic, mml-Neuro-oncology, mml-Pediatric, mml-Pain, mml-Spinal-Cord, mml-Neuro-ophthalmology