Fast results for
The importance of an accurate diagnosis
Multiple sclerosis (MS) is a potentially disabling disease of the brain and spinal cord (central nervous system). Signs and symptoms of MS vary widely, depending on the amount of nerve damage and which nerves are affected. This makes it difficult to diagnose based on clinical symptoms alone. Multiple sclerosis is also commonly mistaken for other treatable autoimmune demyelinating diseases.
An alternative, data-driven approach to diagnose MS
Mayo Clinic Laboratories offers a profile that can assist in the diagnosis of MS by measuring kappa immunoglobin light chains in cerebral spinal fluid (KCSF) with a reflex, if positive, to oligoclonal banding. Propelled by Mayo Clinic-led studies into the presence of kappa IgG biomarkers in the spinal fluid of MS patients, the assay has been optimized for peak antibody detection. This increased sensitivity delivers precision results that set patients on the correct diagnostic pathway.
Rapid turnaround time
Our reflexive testing approach enables same day answers for three-fourths of patients tested. Additional results for oligoclonal banding will be reported within three days.
An automated approach
Unique to Mayo Clinic, our profile is objective, standardized, and not operator dependent, which produces fast, error-free results.
Adheres to diagnostic criteria
Our test meets the widely used McDonald criteria for a positive diagnosis of multiple sclerosis. Our reflexive test for oligoclonal banding utilizes two or more bands to confirm a positive or borderline result of the KCSF test.
A reflexive testing approach
Based on internal studies with Mayo Clinic patients, KCSF will be negative in 75% of cases, which immediately rules out demyelinating disease. For the remaining 25% of borderline or positive KCSF cases — between 0.06 and 0.1 or higher mg/dL — the test will reflex to oligoclonal banding. Both results will be reported to the ordering physician.
When should this test be ordered?
KCSF laboratory testing is strongly recommended:
The use of preclinical data, such as results obtained with imaging studies and laboratory testing, has allowed for more sensitive and specific diagnoses. This leads to earlier disease detection and utilization of interventions and therapies, when they are most beneficial to patients.
For patients suspected of having multiple sclerosis, testing for neurofilament light chain (NfL), a generic marker of neurodegeneration, can confirm a neurodegenerative disease process. Mayo Clinic Laboratories has developed an innovative assay to test for elevated levels of NfL in the blood. Positive test results not only confirm neuronal damage but can offer insights on disease severity, progression and prognosis to guide therapeutic decision-making.
Test in Focus
Maria Alice Willrich, Ph.D., explains kappa free light chain testing — Mayo Clinic Laboratories' data-driven approach to diagnose multiple sclerosis. The automated assay is more sensitive, cost-effective, and faster than traditional oligoclonal banding, enabling definitive answers for the challenging diagnosis.
Testing to distinguish MS from autoimmune demyelinating diseases
Neuromyelitis optica (NMO) is an inflammatory, demyelinating disease of the central nervous system. NMO is characterized by severe relapsing attacks of optic neuritis and transverse myelitis. Unlike the attacks associated with multiple sclerosis, NMO attacks commonly spare the brain in the early stages.
The spectrum of NMO was traditionally restricted to the optic nerves and the spinal cord. In 2004, Mayo Clinic scientist Vanda Lennon, M.D., Ph.D., reported an antibody that targets aquaporin-4 (AQP4), the water channel on astrocytes, which is a sensitive and specific biomarker for NMO. Since that discovery, a much broader category called NMO spectrum disorders (NMOSD) has evolved.