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Relevance of kappa free light chains index in patients with aquaporin-4 or myelin-oligodendrocyte-glycoprotein antibodies.
Deschamps, Romain; Shor, Natalia; Papeix, Caroline; Boudot de la Motte, Marine; Bensa, Caroline; Marignier, Romain; Lecler, Augustin; Vignal-Clermont, Catherine; Ghillani, Pascale; Gazzano, Marianne; Maillart, Elisabeth; Sterlin, Delphine.
Afiliación
  • Deschamps R; Department of Neurology, Hôpital Fondation Adolphe de Rothschild, Paris, France.
  • Shor N; Department of Neuroradiology, Assistance Publique Hôpitaux de Paris, Hôpitaux Universitaires La Pitié Salpêtrière - Sorbonne Université, Paris, France.
  • Papeix C; Department of Neuroradiology, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Paris, France.
  • Boudot de la Motte M; Department of Neurology, Hôpital Fondation Adolphe de Rothschild, Paris, France.
  • Bensa C; Department of Neurology, Hôpital Fondation Adolphe de Rothschild, Paris, France.
  • Marignier R; Department of Neurology, Hôpital Fondation Adolphe de Rothschild, Paris, France.
  • Lecler A; Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon, France.
  • Vignal-Clermont C; Department of Neurology, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation, Lyon, France.
  • Ghillani P; Department of Radiology, Hôpital Fondation Adolphe de Rothschild, Paris, France.
  • Gazzano M; Department of Neuro-Ophthalmolology, Hôpital Fondation Adolphe de Rothschild, Paris, France.
  • Maillart E; Department of Immunology, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Pitié-Salpêtrière, Paris, France.
  • Sterlin D; Department of Immunology, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Pitié-Salpêtrière, Paris, France.
Eur J Neurol ; 30(9): 2865-2869, 2023 09.
Article en En | MEDLINE | ID: mdl-37243935
BACKGROUND: The kappa free light chains index (κ-index) is increasing in importance as a fast, easy, cost-effective, and quantitative biomarker in multiple sclerosis (MS), which can replace cerebrospinal fluid (CSF)-restricted oligoclonal bands (OCB) detection. In previous studies, controls often included mixed patients with several inflammatory central nervous system disorders. The aim of the present study was to assess the κ-index in patients with serum aquaporin-4 (AQP4)-IgG or myelin-oligodendrocyte-glycoprotein (MOG)-IgG. METHODS: We analyzed CSF/serum samples of patients with AQP4-IgG or MOG-Ig and evaluated distinct κ-index cut-offs. We described clinical and magnetic resonance imaging (MRI) features of patients with the highest κ-index values. RESULTS: In 11 patients with AQP4-IgG, median κ-index was 16.8 (range 0.2; 63) and 6/11 (54.5%) had κ-index >12. Among 42 patients with MOG-IgG, 2 had low positive MOG-IgG titers, were ultimately diagnosed with MS, and had a markedly increased κ-index (54.1 and 102.5 respectively). For the remaining 40 MOG-IgG-positive patients the median κ-index was 0.3 (range 0.1; 15.5). Some 6/40 (15%) and 1/40 (2.5%) patients had a κ-index >6 and >12, respectively. None fulfilled MRI dissemination in space and dissemination in time (DIS/DIT) criteria and the final diagnosis was MOG-IgG-associated disease (MOGAD) for these 40 patients. Four of the 40 (10%) MOG-IgG-positive patients had OCB. CONCLUSION: While a marked increase in κ-index could discriminate MS from MOGAD, a low κ-index threshold could lead to confusion between MS and MOGAD or AQP4 antibody-positive neuromyelitis optica spectrum disorder.
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Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Neuromielitis Óptica / Esclerosis Múltiple Límite: Humans Idioma: En Revista: Eur J Neurol Asunto de la revista: NEUROLOGIA Año: 2023 Tipo del documento: Article País de afiliación: Francia

Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Neuromielitis Óptica / Esclerosis Múltiple Límite: Humans Idioma: En Revista: Eur J Neurol Asunto de la revista: NEUROLOGIA Año: 2023 Tipo del documento: Article País de afiliación: Francia