Kappa-index: Real-life evaluation of a new tool for multiple sclerosis diagnosis.
Clin Immunol
; 241: 109066, 2022 08.
Article
en En
| MEDLINE
| ID: mdl-35705146
ABSTRACT
The intrathecal production of oligoclonal immunoglobulin bands (OCB) is a prognostic factor for multiple sclerosis (MS) evolution in clinically isolated syndrome (CIS) patients and a diagnostic factor for MS. The kappa free light chain (K)-index represents a quantitative automated alternative to OCB. We retrospectively evaluated OCB and K-index results in 274 patients with MS (n = 48) or CIS (n = 29) at diagnosis, non-MS inflammatory central nervous diseases (n = 35), and non-inflammatory central/peripheral nervous diseases (n = 162). Several cut-offs were established a pathophysiological cut-off (K-index 3.3) useful for differential diagnosis (negative predictive value for MS >99%), an optimised cut-off (K-index 9.1) with better sensitivity and equivalent specificity than OCB for the diagnosis of MS, and a high-risk cut-off (K-index >55.0) allowing prediction of MS (specificity 100%). We developed a scaled interpretation of the K-index and we discuss the usefulness of testing OCB only when the K-index is positive >3.3 to obtain a better specificity.
Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Enfermedades Desmielinizantes
/
Esclerosis Múltiple
Tipo de estudio:
Diagnostic_studies
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Observational_studies
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Prognostic_studies
/
Risk_factors_studies
Límite:
Humans
Idioma:
En
Revista:
Clin Immunol
Asunto de la revista:
ALERGIA E IMUNOLOGIA
Año:
2022
Tipo del documento:
Article