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Clinical Chemistry 48: 167-173, 2002;
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(Clinical Chemistry. 2002;48:167-173.)
© 2002 American Association for Clinical Chemistry, Inc.

Detection of Oligoclonal Immunoglobulins in Cerebrospinal Fluid by an Immunofixation-Peroxidase Method

Sophie Richard1, Véronique Miossec1, Jean-François Moreau1 and Jean-Luc Taupin1a

1 Laboratory of Immunology, Centre Hospitalier Régional et Universitaire de Bordeaux, 33076 Bordeaux, France.

aAddress correspondence to this author at: Laboratory of Immunology, Groupe Hospitalier Pellegrin, Place Amélie Raba-Léon, 33076 Bordeaux Cedex, France. Fax 33-5-57-57-14-72; e-mail jean-luc.taupin{at}chu-bordeaux.fr.

Background: The detection of intrathecal synthesis of immunoglobulins is used in the diagnosis of multiple sclerosis (MS). We tested the semiautomated immunofixation-peroxidase (IFPOD) technique, which uses high-resolution agarose gel electrophoresis (HRAGE) directly followed by immunofixation with a peroxidase-labeled anti-IgG antiserum to detect oligoclonal immunoglobulins in cerebrospinal fluid (CSF).

Methods: We analyzed 230 consecutive matched serum/CSF pairs that arrived in the laboratory over a 6-month period with both IFPOD and our routine techniques, immunofixation electrophoresis (IFE) and HRAGE. For IFPOD, CSF samples were not concentrated before testing.

Results: Among the 230 samples were 12 clinically definite MS, 33 clinically probable, and 20 clinically possible MS samples. IFPOD and HRAGE + IFE each detected oligoclonal IgG in CSF in 10, 16, and 7 cases of these respective groups. For clinically definite MS, sensitivity and specificity (95% confidence intervals) were, respectively, 83% (51–97%) and 79% (73–84%).

Conclusions: The IFPOD technique performs comparably to other analytical methods, without the requirement for sample concentration, and may represent an attractive alternative in testing for intrathecal immunoglobulin synthesis.




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