Which of the following is seen in the CSF in a patient with multiple sclerosis?
Elevated IgG
Galactomannan
Decreased oligoclonal bands
Carbohydrate deficient transferrin
Decreased CSF myelin basic protein
Show Answer and Explanations
Elevated IgG — Correct answer
Correct. The CSF of MS patients shows elevated IgG with an increased IgG / albumin index, and oligoclonal bands.
Galactomannan
Incorrect. Galactomannan is an indicator of invasive aspergillosis.
Decreased oligoclonal bands
Incorrect. The CSF of MS patients shows the presence of oligoclonal bands.
Carbohydrate deficient transferrin
Incorrect. Carbohydrate deficient transferrin is a marker of ethanol use. Other findings include an elevated serum AST/ALT ratio, elevated GGT and macrocytosis in the peripheral blood. Ethyl glucuronide also persist in the body after ethanol has been metabolized.
Decreased CSF myelin basic protein
Incorrect. CSF MBP is frequently increased in the CSF of MS patients, but tends to not add to the sensitivity or specificity of oligoclonal bands. It is sometimes used as a marker of active MS, i.e. an indicator of MS out of remission.
Summary
Summary: The CSF in multiple sclerosis patients shows oligoclonal bands, elevated IgG and elevated myelin basic protein.