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- W1497297175 abstract "OBJECTIVE: To evaluate the differences in CSF determinants between patients suffering from acute transverse myelitis (ATM) caused by confirmed or probable multiple sclerosis (MS) and ATM caused by other defined inflammation or infection. BACKGROUND: Acute transverse myelitis is an etiologically heterogenous syndrome. A thorough diagnostic work-up is necessary to identify the cause and to enable prompt treatment when needed. Unfortunately, in many instances, the results for oligoclonal banding and specific microbiological tests are not available during the most acute phase. DESIGN/METHODS: All patients with ATM and without history suggestive of MS who were treated in Turku University Hospital and Paijat-Hame Central Hospital, Finland during 2002-2010 were included. The CSF leukocytes, protein levels, oligoclonal bands and IgG indices were determined in each etiological group. The sensitivity, specificity and predictive values of these determinants for differentiating MS from other inflammatory ATM were estimated. Conversion to MS during five-year follow-up was evaluated. RESULTS: Sixty-five patients with ATM were identified. In 26 patients with final diagnosis of confirmed or probable MS, the CSF leukocyte count and protein level were significantly lower than among 19 patients with other inflammatory ATM. The test combination of an elevated IgG-index and normal CSF protein level had the specificity and the positive predictive value of 100 % to detect confirmed or probable MS. With this test combination conversion rate to MS was 81%. CONCLUSIONS: If CSF yields marked pleocytosis or raised protein content, the MS-etiology for ATM is improbable. If intrathecal IgG synthesis is detected in otherwise normal CSF, the MS-etiology is very probable. In our study, the combination of the results of CSF protein concentration and IgG index was extremely valuable: all patients having normal protein level with elevated IgG index were diagnosed with MS or were at high risk for this disease. Study Supported by: Disclosure: Dr. Kupila has nothing to disclose. Dr. Jaakonmaki has nothing to disclose. Dr. Huhtala has nothing to disclose. Dr. Airas has nothing to disclose." @default.
- W1497297175 created "2016-06-24" @default.
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- W1497297175 date "2014-04-08" @default.
- W1497297175 modified "2023-09-28" @default.
- W1497297175 title "Acute Transverse Myelitis: CSF Determinants In The Differential Diagnostics (P5.180)" @default.
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