Sistema de Salut de Catalunya
Institut Català de la Salut
[Deisenhammer F, Hegen H] Department of Neurology, Innsbruck Medical University, Innsbruck, Austria. [Arrambide G] Servei de Neurologia-Neuroimmunologia, Centre d’Esclerosi Múltiple de Catalunya (CEMCAT), Barcelona, Spain. Vall d’Hebron Hospital Universitari, Barcelona, Spain. Universitat Autònoma de Barcelona, Barcelona, Spain. [Banwell BL] Department of Pediatrics, Johns Hopkins University, Baltimore, USA. [Coetzee T] National Multiple Sclerosis Society, New York, NY, USA. [Gnanapavan S] Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK. [Montalban X] Servei de Neurologia-Neuroimmunologia, Centre d’Esclerosi Múltiple de Catalunya (CEMCAT), Barcelona, Spain. Vall d’Hebron Hospital Universitari, Barcelona, Spain. Universitat Autònoma de Barcelona, Barcelona, Spain. Universitat de Vic/Central de Catalunya (UVic-UCC), Spain
Vall d'Hebron Barcelona Hospital Campus
2025-11-17T07:27:42Z
2025-11-17T07:27:42Z
2025-10
Cerebrospinal fluid; Criteria; Diagnosis
Líquido cefalorraquídeo; Criterios; Diagnóstico
Líquid cefaloraquidi; Criteris; Diagnòstic
The 2024 McDonald diagnostic criteria for Multiple Sclerosis (MS) introduce kappa free light chains (κ-FLC) detection in cerebrospinal fluid (CSF) which can be used interchangeably with oligoclonal IgG bands (OCB) to demonstrate intrathecal immunoglobulin synthesis. Diagnostic sensitivity and specificity of κ-FLC is equal to OCB on a 95% confidence level. In rare cases determination of both, κ-FLC and OCB should be considered as the concordance rate is around 90%. We recommend calculating the κ-FLC index with values of ≥6.1 performing best for diagnosing MS. Validated turbidimetric or nephelometric assays should be applied for which proficiency testing programs are available. There is some prognostic use of the κ-FLC index with higher values predicting higher disease activity. Neurofilament light (NfL) should not be used for diagnostic purposes although it might be useful for prognosis and disease monitoring. All recommendations apply to paediatric and adult relapsing as well as progressive onset MS.
Article
Published version
English
Esclerosi múltiple - Diagnòstic; Líquid cefaloraquidi; DISEASES::Nervous System Diseases::Autoimmune Diseases of the Nervous System::Demyelinating Autoimmune Diseases, CNS::Multiple Sclerosis; Other subheadings::Other subheadings::/diagnosis; ANATOMY::Fluids and Secretions::Body Fluids::Extracellular Fluid::Cerebrospinal Fluid; ENFERMEDADES::enfermedades del sistema nervioso::enfermedades autoinmunitarias del sistema nervioso::enfermedades autoinmunes desmielinizantes del SNC::esclerosis múltiple; Otros calificadores::Otros calificadores::/diagnóstico; ANATOMÍA::líquidos y secreciones::líquidos corporales::líquido extracelular::líquido cefalorraquídeo
Elsevier
eBioMedicine;120
https://doi.org/10.1016/j.ebiom.2025.105905
Attribution 4.0 International
http://creativecommons.org/licenses/by/4.0/
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