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SHR Neuro Krebs Kardio Lipid

Leurs, CE; Twaalfhoven, H; Lissenberg-Witte, BI; van Pesch, V; Dujmovic, I; Drulovic, J; Castellazzi, M; Bellini, T; Pugliatti, M; Kuhle, J; Villar, LM; Alvarez-Cermeño, JC; Alvarez-Lafuente, R; Hegen, H; Deisenhammer, F; Walchhofer, LM; Thouvenot, E; Comabella, M; Montalban, X; Vécsei, L; Rajda, C; Galimberti, D; Scarpini, E; Altintas, A; Rejdak, K; Frederiksen, JL; Pihl-Jensen, G; Jensen, P; Khalil, M; Voortman, MM; Fazekas, F; Saiz, A; La Puma, D; Vercammen, M; Vanopdenbosch, L; Uitdehaag, B; Killestein, J; Bridel, C; Teunissen, C.
Kappa free light chains is a valid tool in the diagnostics of MS: A large multicenter study.
Mult Scler. 2019; 15:1352458519845844-1352458519845844
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Autor/innen der Med Uni Graz:
Fazekas Franz
Khalil Michael
Voortman Margarete
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Abstract:
To validate kappa free light chain (KFLC) and lambda free light chain (LFLC) indices as a diagnostic biomarker in multiple sclerosis (MS). We performed a multicenter study including 745 patients from 18 centers (219 controls and 526 clinically isolated syndrome (CIS)/MS patients) with a known oligoclonal IgG band (OCB) status. KFLC and LFLC were measured in paired cerebrospinal fluid (CSF) and serum samples. Gaussian mixture modeling was used to define a cut-off for KFLC and LFLC indexes. The cut-off for the KFLC index was 6.6 (95% confidence interval (CI) = 5.2-138.1). The cut-off for the LFLC index was 6.9 (95% CI = 4.5-22.2). For CIS/MS patients, sensitivity of the KFLC index (0.88; 95% CI = 0.85-0.90) was higher than OCB (0.82; 95%CI = 0.79-0.85; p < 0.001), but specificity (0.83; 95% CI = 0.78-0.88) was lower (OCB = 0.92; 95% CI = 0.89-0.96; p < 0.001). Both sensitivity and specificity for the LFLC index were lower than OCB. Compared with OCB, the KFLC index is more sensitive but less specific for diagnosing CIS/MS. Lacking an elevated KFLC index is more powerful for excluding MS compared with OCB but the latter is more important for ruling in a diagnosis of CIS/MS.

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