Multiple sclerosis in Brazil: analisys of cerebrospinal fluid by standard methods

RESUMO

The demonstration of intrathecal IgG synthesis has been used as an important laboratory parameter to support the diagnosis of multiple sclerosis (MS). The Committee for European Concerted Action for Multiple Sclerosis has recommended a protocol for the assessment of intrathecal IgG synthesis. We applied this methodology to determine the cerebrospinal (CSF) profile of 128 Brazilian patients with MS. We detected hypercytosis lower than 35 cells/mm3 in 97 per cent, protein lower than 80mg/dl in 99 per cent, normal blood-CSF barrier function in 76 per cent, increased IgG local production around 53 per cent and oligoclonal IgG bands by isoelectric focosing in 85 per cent of the definite MS patients. The diagnostic accuracy of the quantitative analysis was lower than the qualitative. The detection of oligoclonal bands was especially important in the cases of normal quantitative assays of IgG. In addition, we found a lower frequency of inflammatory reaction in CSF in our MS cases, in comparison to some European studies.