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- Multiple Sclerosis
- OSF - 11
- Pages 243 & 244
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- Mechanism of Disease:
- ecause is unknown
- ebelief is that genetic and environmental factors play a role
- ˇGenetic factors:
- these two HLA antigens are present in patient=s with MS
- ~DRw15
- ~DQw6
- ˇEnvironmental factors:
- ~inflammatory immune response to bacterial and viral infections may
trigger autoimmune response seen in MS patients
- e80% of MS patients have IgG produced in CSF that is directed against
basic protein of myelin sheath.
This results in demyelination and formation of lesions called Aplaques@
in white matter of brain and spinal cord
- edemyelination may cause:
- visual distrubances
- lack of locomotor coordination
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- Laboratory findings:
- eit is important to determine source of IgG in CSF
- ˇis it produced in the spinal cord
- ˇis it produced elsewhere and has crossed the blood- brain barrier
- etwo assays used to determine origin of IgG in CSF:
- ˇoligoclonal banding technique:
- ~protein electrophoresis of CSF shows multiple bands in the ( region
- ~protein electrophoresis of serum shows multiple bands in the ( region
- ~if isoelectric focusing used:
- qCSF shows band pattern in ( region
- qserum shows no band pattern in ( region
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- etwo assays used to determine origin of IgG in CSF: cont=d
- ˇCSF IgG index technique:
- ~this is a calculation that uses the ratio of IgG to albumin in both
serum and CSF
- CSF IgG index =
- IgGCSF ) albuminCSF
- IgGserum ) albuminserum
- ~interpretation of results:
- q0.0 - 0.77
- q> 0.77
- serum IgG in CSF
- IgG produced in CSF
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Notes
