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Test Code LAB10578 Oligoclonal Banding, Serum and Spinal Fluid

Important Note

Cerebrospinal Fluid and Serum Required for Testing.

Reporting Name

Oligoclonal Banding

Useful For

Diagnosis of multiple sclerosis; especially useful in patients with equivocal clinical presentation and radiological findings

Profile Information

Test ID Reporting Name Available Separately Always Performed
OLIGS Serum Bands No Yes
OLIGC CSF Bands No Yes

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Specimen Type

CSF
Serum


Specimen Required


Both serum and spinal fluid are required. Spinal fluid must be obtained within 7 days of serum collection.

 

Specimen Type: Serum

Container/Tube:

Preferred: Serum gel

Acceptable: Red top

Specimen Volume: 0.5 mL

Collection Instructions:

1. Centrifuge and aliquot serum within 2 hours of collection.

2. Label specimen as serum.

 

Specimen Type: Spinal fluid

Container/Tube: Sterile vial

Specimen Volume: 0.5 mL

Collection Instructions: Label specimen as spinal fluid.


Specimen Minimum Volume

Serum, Spinal Fluid: 0.4 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
CSF Refrigerated (preferred) 14 days
  Ambient  14 days
  Frozen  14 days
Serum Refrigerated (preferred) 14 days
  Ambient  14 days
  Frozen  14 days

Reference Values

CSF Oligoclonal Bands Interpretation: <2 bands

Day(s) Performed

Monday through Friday

Test Classification

This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.

CPT Code Information

83916 x 2

LOINC Code Information

Test ID Test Order Name Order LOINC Value
OLIG Oligoclonal Banding In Process

 

Result ID Test Result Name Result LOINC Value
8017 CSF Bands 49852-7
2783 Serum Bands In Process
23611 CSF Olig Bands Interpretation In Process

Clinical Information

The diagnosis of multiple sclerosis (MS) is dependent on clinical, radiological, and laboratory findings. The detection of increased intrathecal immunoglobulin synthesis is the basis for current diagnostic laboratory tests for MS. These tests include the measurement of kappa free light chains in cerebrospinal fluid (CSF) and CSF oligoclonal band (OCB) detection. Abnormal CSF OCB patterns have been reported in 70% to 80% of MS patients.

 

Increased intrathecal Ig synthesis may occur in other inflammatory CSF diseases and, therefore this assay is not specific for MS.

Interpretation

When the oligoclonal band assay detects 2 or more unique IgG bands in the cerebrospinal fluid (CSF), the result is positive.

 

CSF is used in the diagnosis of multiple sclerosis (MS) by identifying increased intrathecal IgG synthesis qualitatively (oligoclonal bands). The presence of 2 or more unique CSF oligoclonal bands was reintroduced as one of the diagnostic criteria for MS in the 2017 revised McDonald criteria. These findings, however, are not specific for MS as CSF-specific IgG synthesis may also be found in patients with other neurologic diseases including infectious, inflammatory, cerebrovascular, and paraneoplastic disorders. Clinical correlation recommended.

Method Description

The oligoclonal band (OCB) assay requires paired cerebrospinal fluid (CSF) and serum samples. Unconcentrated CSF and diluted serum are electrophoresed by isoelectric focusing. The separated immunoglobulins (Ig) are visualized by an IgG immunoblot, and OCBs that are present in the CSF and not in the serum are reported. The assay uses reagents from Helena Laboratories.(Keir G, Luxton RW, Thompson EJ: Isoelectric focusing of cerebrospinal fluid immunoglobulins G: an annotated update. Ann Clin Biochem 1990;27:436-443; Hortin GL: Amino Acids, Peptides, and Proteins. In: Burtis CA, Bruns DE, eds. Tietz Fundamentals of Clinical Chemistry and Molecular Diagnostics. 7th ed. Elsevier; 2015:chap 18)

Report Available

2 to 3 days

Reject Due To

Gross hemolysis OK
Gross lipemia OK
Gross icterus OK

Method Name

Isoelectric Focusing (IEF) with IgG Immunoblot Detection

Secondary ID

8017