Aa
CSF question , please help
Hi to all
I have my CSF tested couple of years ago .
MYEL BASIC PROTEIN 2.60 f 0.07 - 4.10 ng /ml
What catches my eye is the information under quote " - Test information : Myelin Basic Protein
This test uses a kit designated by manufacturer as for research use , not for
clinical use . The performance characteristics of this test were validated by
ARUP Laboratories Inc. The US Food and Drug Administration ( FDA) has
not approved this test . The results are not intended to be used as the sole
means for clinical diagnosis or patient management decisions. ARUP is autho-
rized under Clinical Laboratory Improvement Amendments (CLIA) and by all
states to perform high complexity testing ."-
Tubes Rec 4
Total volume 11.0
Color Colorless
Appearance Clear
CSF CSF
RBC Cell Ct 0
NUC Cell Ct 1
CSF Polys 2
CSF Lymphs 95 H
CSF Macropha 3 L
Differential based on 62 cells counted on double concentrated cytospin smear
CSF Glucose 63 40 - 70 MG/ DL
CSF Protein 43 15 - 45 MG/DL
MS Panel
IGG Serum 885 768 - 1632 mg /dl
IGG CSF 2.0 0.0 - 6.0 mg/dl
Albumin Serum 4470 3500 - 5200 mg/dl
Albumin CSF 24 0 - 35 mg/dl
Albumin Inde 5.4 0.0 - 9.0 ratio
Synthesis Ra 0.0 0.0 - 8.0 mg/dl
IGG Index 0.42 0.28 - 0.66 ratio
IGG Albumin 0.08 L 0.09 - 0.25 ratio
Oligoclonal band Neg
Please tell me if the H and low numbers should be addressed and also if the 2.60 f Myelin Basic Protein is the number for oligoclonal bands ?
Vanda
I have my CSF tested couple of years ago .
MYEL BASIC PROTEIN 2.60 f 0.07 - 4.10 ng /ml
What catches my eye is the information under quote " - Test information : Myelin Basic Protein
This test uses a kit designated by manufacturer as for research use , not for
clinical use . The performance characteristics of this test were validated by
ARUP Laboratories Inc. The US Food and Drug Administration ( FDA) has
not approved this test . The results are not intended to be used as the sole
means for clinical diagnosis or patient management decisions. ARUP is autho-
rized under Clinical Laboratory Improvement Amendments (CLIA) and by all
states to perform high complexity testing ."-
Tubes Rec 4
Total volume 11.0
Color Colorless
Appearance Clear
CSF CSF
RBC Cell Ct 0
NUC Cell Ct 1
CSF Polys 2
CSF Lymphs 95 H
CSF Macropha 3 L
Differential based on 62 cells counted on double concentrated cytospin smear
CSF Glucose 63 40 - 70 MG/ DL
CSF Protein 43 15 - 45 MG/DL
MS Panel
IGG Serum 885 768 - 1632 mg /dl
IGG CSF 2.0 0.0 - 6.0 mg/dl
Albumin Serum 4470 3500 - 5200 mg/dl
Albumin CSF 24 0 - 35 mg/dl
Albumin Inde 5.4 0.0 - 9.0 ratio
Synthesis Ra 0.0 0.0 - 8.0 mg/dl
IGG Index 0.42 0.28 - 0.66 ratio
IGG Albumin 0.08 L 0.09 - 0.25 ratio
Oligoclonal band Neg
Please tell me if the H and low numbers should be addressed and also if the 2.60 f Myelin Basic Protein is the number for oligoclonal bands ?
Vanda
Wow , nobody ever explained it to me this way . Thank you so very much .
I understand this is just another test which may be helpful in Dx .
Yes , I do have clinical history consistent with MS , as stated by MS neuro , and also MRI with multiple lesions .
I have been Dx in Sept 2007 and than in May of 2008 I have been told that since the load of lesions have not change , this is probably not MS .
Since than I have changed my neuro ( the first one left the town ), and my new MRI showed additional lesions in my brain , one lesion in cervical spine and one in thoracic .
I am going to see the neuro on this coming Wednesday
I will post the updates .
Thank you Quix for this explanation of my results .
Vanda
I understand this is just another test which may be helpful in Dx .
Yes , I do have clinical history consistent with MS , as stated by MS neuro , and also MRI with multiple lesions .
I have been Dx in Sept 2007 and than in May of 2008 I have been told that since the load of lesions have not change , this is probably not MS .
Since than I have changed my neuro ( the first one left the town ), and my new MRI showed additional lesions in my brain , one lesion in cervical spine and one in thoracic .
I am going to see the neuro on this coming Wednesday
I will post the updates .
Thank you Quix for this explanation of my results .
Vanda
So good to see you!
Your CSF results are all normal with the exception of the Myelin Basic Protein, MBP. It was thought a few years ago that the MBP might be a marker for MS, but it has been shown that it can be elevated during many different disease processes, like viral syndromes. So, it has not shown to be of specific use except as a general indicator that there is myelin metabolism going on in the central nervous system - meaning myelin breakdown and repair, where lots of MBP is being made and is floating around in the CSF. So, it's the kind of info that would support a Dx of MS, but not on it's own.
The High Value is for the cell "percentages." Your actual cell count was 1 WBC seen per tiny drop of fluid. That is well within normal range. When they spun the big sample down to collect all the cells they could, they then counted enough cells to see what cells were there. They were able to count 62 cells and 95 % of them were lymphocytes, 2 % were macrophages (monocytes) and 3% were lymphocytes. (The sum of 95 + 2 +3 = 100 percent). In general, you would expect to see as a more equal distribution of the differnt kinds of cells.
This would support a "theory" that at some time in the recent past before this LP, you had had an infection, likely a viral infection in your central nervous system. During a viral meningitis, for example, the CSF will show an elevated WBC count and most of the cells will be lymphocytes. (During a bacterial meningitis, like HIB or meningococcal, there will be usually greater than 95% neutrophils.) Going along with this theory is the elvated Myelin Basic Protein which will often be elevated during a viral infection of the brain and meninges. (The meninges are the fibrous linings around the brain and cord.)
In general, neutrophils fight bacteria and lymphocytes fight viruses (and other things). Macrophages (macro=large, phage=eaters) are the debris cleanup crew.
In MS you would expect a normal cell count.
So the High value suggests a little to us. The Low value is meaningless.
The only parts of the MS CSF panel that mean anything are the IgG Index (which is normal) and the O-Band number. The rest of those things have to be obtained ONLY in order to determine (calculate) the IgG Index. They are not usually looked at individually.
A lot of talk to say that your results, taken by themselves, sort of suggest that you were just past a viral infection in your CNS. They do not PROVE that, however. No, there is nothing to worry about here or to point specifically toward MS.
Does that help?
Quix
Your CSF results are all normal with the exception of the Myelin Basic Protein, MBP. It was thought a few years ago that the MBP might be a marker for MS, but it has been shown that it can be elevated during many different disease processes, like viral syndromes. So, it has not shown to be of specific use except as a general indicator that there is myelin metabolism going on in the central nervous system - meaning myelin breakdown and repair, where lots of MBP is being made and is floating around in the CSF. So, it's the kind of info that would support a Dx of MS, but not on it's own.
The High Value is for the cell "percentages." Your actual cell count was 1 WBC seen per tiny drop of fluid. That is well within normal range. When they spun the big sample down to collect all the cells they could, they then counted enough cells to see what cells were there. They were able to count 62 cells and 95 % of them were lymphocytes, 2 % were macrophages (monocytes) and 3% were lymphocytes. (The sum of 95 + 2 +3 = 100 percent). In general, you would expect to see as a more equal distribution of the differnt kinds of cells.
This would support a "theory" that at some time in the recent past before this LP, you had had an infection, likely a viral infection in your central nervous system. During a viral meningitis, for example, the CSF will show an elevated WBC count and most of the cells will be lymphocytes. (During a bacterial meningitis, like HIB or meningococcal, there will be usually greater than 95% neutrophils.) Going along with this theory is the elvated Myelin Basic Protein which will often be elevated during a viral infection of the brain and meninges. (The meninges are the fibrous linings around the brain and cord.)
In general, neutrophils fight bacteria and lymphocytes fight viruses (and other things). Macrophages (macro=large, phage=eaters) are the debris cleanup crew.
In MS you would expect a normal cell count.
So the High value suggests a little to us. The Low value is meaningless.
The only parts of the MS CSF panel that mean anything are the IgG Index (which is normal) and the O-Band number. The rest of those things have to be obtained ONLY in order to determine (calculate) the IgG Index. They are not usually looked at individually.
A lot of talk to say that your results, taken by themselves, sort of suggest that you were just past a viral infection in your CNS. They do not PROVE that, however. No, there is nothing to worry about here or to point specifically toward MS.
Does that help?
Quix
Hi Lulu
Yes he did but he was not a great communicator and he also mentioned something about different interpretation by different standard , but at that time I was scared to death and not ready to face any of this .
Currently I have a new neuro , because my first one left town .
The new one listen more and talk more and I feel like I can communicate better .
Hope to know little more soon .
Thank you very much for your input .
Vanda
Yes he did but he was not a great communicator and he also mentioned something about different interpretation by different standard , but at that time I was scared to death and not ready to face any of this .
Currently I have a new neuro , because my first one left town .
The new one listen more and talk more and I feel like I can communicate better .
Hope to know little more soon .
Thank you very much for your input .
Vanda
oops, I just reread and see that these results are two years old. did your neuro interpret these results for you back then?
Hi Vanda,
I am absolutely no good at reading lab results, but if you look at that very last line it reads the no o-bands were found. ... "oligoclonal band NEG" negative for bands in the four vials of csf taken.
The L and H numbers are so close to normal range that I don't believe your doctor will want to do anything about them. Agian, that's just mhy guess.
Overall it looks like your CSF results are good. Have you seen your neuro yet to discuss them?
no expert,
Lulu
I am absolutely no good at reading lab results, but if you look at that very last line it reads the no o-bands were found. ... "oligoclonal band NEG" negative for bands in the four vials of csf taken.
The L and H numbers are so close to normal range that I don't believe your doctor will want to do anything about them. Agian, that's just mhy guess.
Overall it looks like your CSF results are good. Have you seen your neuro yet to discuss them?
no expert,
Lulu
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