Introduction
Patients and methods
Patients
Evaluation of the humoral immune response
Evaluation of the blood–CSF barrier
Cytological examination, total CSF protein, and l-lactate
Statistics
Results
Patient characteristics
Cellular immune response
Units | Total | Attack | Remission | Acute MY subgroup | Acute ON subgroup | Acute BRAIN subgroup | |
---|---|---|---|---|---|---|---|
CSF white cell counts | |||||||
Pleocytosis | Samples | 56/103 (54.4%) | 53/91 (58.2%) | 3/11 (27.3%) | 24/29 (82.8%) | 5/26 (19.2%) | 24/36 (66.7%) |
WCC, all samples | Cells/μl | 11.5 (0–256; 102) | 14 (0–256; 91) | 4 (0–35; 11) | 41 (2–256; 29) | 2 (0–18; 25) | 22 (0–179; 36) |
WCC, if elevated | Cells/μl | 40 (6–256; 56) | 42 (6–256; 53) | 23 (18–35; 3) | 70.5 (13–256; 24) | 10 (6–18; 5) | 44.5 (9–179; 24) |
WCC, ≥ 100 | Samples | 11/103 (10.7%) | 11/91 (12.1%) | 0/11 (0%) | 9/29 (31%) | 0/26 (0%) | 2/36 (5.6%) |
WCC, ≥ 100 | Cells/μl | 179 (103–256; 11) | 179 (103–256; 11) | n.a. (n.a.; 0) | 179 (103–256; 9) | n.a. (n.a; 0) | 176 (173–179; 2) |
Lymphocytes | Samples | 45/45 (100%) | 43/43 (100%) | 2/2 (100%) | 20/20 (100%) | 11/11 (100%) | 12/12 (100%) |
Monocytes | Samples | 35/45 (77.8%) | 34/43 (79.1%) | 1/2 (50%) | 15/20 (75%) | 7/11 (63.6%) | 12/12 (100%) |
Neutrophils | Samples | 32/45 (71.1%) | 31/43 (72.1%) | 1/2 (50%) | 15/20 (75%) | 5/11 (45.5%) | 11/12 (91.7%) |
Eosinophils | Samples | 3/45 (6.7%) | 3/43 (7%) | 0/2 (0%) | 2/20 (10%) | 0/11 (0%) | 1/12 (8.3%) |
Basophils | Samples | 2/45 (4.4%) | 2/43 (4.7%) | 0/2 (0%) | 1/20 (5%) | 1/11 (9.1%) | 0/12 (0%) |
Plasma cells | Samples | 2/45 (4.4%) | 2/43 (4.7%) | 0/2 (0%) | 1/20 (5%) | 0/11 (0%) | 1/12 (8.3%) |
Lymphoid cells | Samples | 3/45 (6.7%) | 3/43 (7%) | 0/2 (0%) | 2/20 (10%) | 1/11 (9.1%) | 0/12 (0%) |
Macrophages | Samples | 3/45 (6.7%) | 3/43 (7%) | 0/2 (0%) | 1/20 (5%) | 2/11 (18.2%) | 0/12 (0%) |
No pleocytosis | Samples | 47/103 (45.6%) | 38/91 (41.8%) | 8/11 (72.7%) | 5/29 (17.2%) | 21/26 (80.8%) | 12/36 (33.3%) |
Intrathecal IgG synthesis
Units | Total | Attack | Remission | Acute MY subgroup | Acute ON subgroup | Acute BRAIN subgroup | |
---|---|---|---|---|---|---|---|
Intrathecal IgG synthesis | |||||||
OCB positive or IgG-IF ≥ 10% | Samples | 14/97 (14.4%) | 14/87 (16.1%) | 0/8 (0%) | 8/28 (28.6%) | 0/27 (0%) | 6/32 (18.8%) |
OCB positive | Samples | 11/96 (11.5%) | 11/86 (12.8%) | 0/8 (0%) | 7/28 (25%) | 0/26 (0%) | 4/31 (12.9%) |
OCB pattern 1 | Samples | 77/96 (80.2%) | 68/86 (79.1%) | 7/8 (87.5%) | 19/28 (67.9%) | 24/26 (92.3%) | 24/31 (77.4%) |
OCB pattern 2 | Samples | 7/96 (7.3%) | 7/86 (8.1%) | 0/8 (0%) | 6/28 (21.4%) | 0/26 (0%) | 1/31 (3.2%) |
OCB pattern 3 | Samples | 4/96 (4.2%) | 4/86 (4.7%) | 0/8 (0%) | 1/28 (3.6%) | 0/26 (0%) | 3/31 (9.7%) |
OCB pattern 4 | Samples | 7/96 (7.3%) | 6/86 (7%) | 1/8 (12.5%) | 2/28 (7.1%) | 2/26 (7.7%) | 2/31 (6.5%) |
OCB pattern 5 | Samples | 1/96 (1%) | 1/86 (1.2%) | 0/8 (0%) | 0/28 (0%) | 0/26 (0%) | 1/31 (3.2%) |
OCB pattern 2 or 3 | Samples | 11/96 (11.5%) | 11/86 (12.8%) | 0/8 (0%) | 7/28 (25%) | 0/26 (0%) | 4/31 (12.9%) |
OCB pattern 3 or 4 | Samples | 11/96 (11.5%) | 10/86 (11.6%) | 1/8 (12.5%) | 3/28 (10.7%) | 2/26 (7.7%) | 5/31 (16.1%) |
OCB pattern 1, 4, or 5 | Samples | 85/96 (88.5%) | 75/86 (87.2%) | 8/8 (100%) | 2/28 (75%) | 2/26 (100%) | 3/31 (87.1%) |
QIgG > Qlim(IgG) | Samples | 14/78 (18%) | 13/69 (19%) | 0/7 (0%) | 8/23 (34.8%) | 1/21 (4.8%) | 4/25 (16%) |
QIgG, all LPs | – | 2.3 (0.8–8.2; 76) | 2.4 (0.8–8.2; 68) | 1.6 (1.3–1.7; 6) | 3.13 (0.83–8.06; 22) | 1.61 (0.84–8.16; 20) | 2.3 (0.95–7.94; 26) |
QIgG, if positive | – | 2.4 (1.5–7; 14) | 2.4 (1.5–7; 13) | n.a. (n.a.; 0) | 2.64 (1.79–6.97; 8) | 1.53 (1.53–1.53; 1) | 2.3 (1.66–4.22; 4) |
IgG IF, all LPs | %IgGCSF | 0 (0-27; 75) | 0 (0-27; 67) | 0 (0-0; 6) | 0 (0-13.2; 22) | 0 (0-4.4; 20) | 0 (0-27; 25) |
IgG IF, QIgG pos | %IgGCSF | 7.6 (0.03–27; 14) | 7.8 (0–27; 13) | n.a. (n.a.; 0) | 7.6 (0–13.2; 8) | 4.4 (4.4–4.4; 1) | 17.9 (4–27; 4) |
IgG IF, > 10% | Samples | 6/75 (8%) | 6/67 (9%) | 0/6 (0%) | 3/22 (13.6%) | 0/20 (0%) | 3/25 (12%) |
IgG Loc, all LPs | mg/l | 0 (0–15.4; 75) | 0 (0–15.4; 67) | 0 (0–0; 6) | 0 (0–4.8; 22) | 0 (0–15.4; 25) | 0 (0–15.4; 67) |
IgG Loc, QIgG pos | mg/l | 2.4 (0–15.4; 14) | 2.5 (0–15.4; 13) | n.a. (n.a.; 0) | 2.7 (0–4.8; 8) | 0.6 (0.6–0.6; 1) | 3.8 (0.9–15.4; 4) |
IgG CSF, all LPs | mg/l | 21.6 (5.4–107; 79) | 24.6 (5.4–107; 71) | 14.8 (10–21.6; 6) | 37.6 (5.7–107; 22) | 15.1 (5.4–72.6; 20) | 22.8 (9–79.9; 29) |
IgG CSF, QIgG pos | mg/l | 22.5 (13.7–74.3; 14) | 22.8 (13.7–74.3; 13) | n.a. (n.a.; 0) | 27.9 (20–74.3; 8) | 13.7 (13.7–13.7; 1) | 22.5 (19–57; 4) |
IgG serum, all LPs | g/l | 9.6 (3.1–46.9; 78) | 9.9 (3.1–46.9; 70) | 9 (6.3–13.9; 6) | 10.66 (5.27–46.9; 23) | 9.29 (5.69–11.6; 20) | 9.61 (3.11–15.3; 27) |
IgG serum, QIgG pos | g/l | 10.4 (6.2–13.8; 14) | 10.7 (6.2–13.8; 13) | n.a. (n.a.; 0) | 10.7 (6.2–12.7; 8) | 9 (9–9; 1) | 11.9 (7.8–13.8; 4) |
Link index, all | Samples | 10/75 (13%) | 10/67 (15%) | 0/6 (0%) | 5/22 (22.7%) | 1/20 (5%) | 4/25 (16%) |
Link index, if positive | Index | 0.8 (0.7–0.9; 10) | 0.8 (0.7–0.9; 10) | n.a. (n.a.; 0) | 0.8 (0.7–0.8; 5) | 0.7 (0.7–0.7; 1) | #Value! |
Intrathecal IgM synthesis
Units | Total | Attack | Remission | Acute MY subgroup | Acute ON subgroup | Acute BRAIN subgroup | |
---|---|---|---|---|---|---|---|
Intrathecal IgM synthesis | |||||||
QIgM > Qlim(IgM) | Samples | 16/65 (25%) | 16/57 (28%) | 0/6 (0%) | 9/18 (50%) | 4/17 (24%) | 3/22 (14%) |
QIgM, all LPs | – | 0.4 (0–7.3; 63) | 0.5 (0–7.3; 56) | 0.2 (0.1–0.5; 5) | 0.79 (0–6.72; 17) | 0.35 (0–7.33; 16) | 0.38 (0–4.17; 23) |
QIgM, if positive | – | 1.7 (0.4–7.3; 16) | 1.7 (0.4–7.3; 16) | n.a. | 1.8 (0.45–6.72; 9) | 0.76 (0.39–7.33; 4) | 1.[74 (1.73–1.81; 3) |
IgM IF, all LPs | %IgMCSF | 0 (0–71.3; 62) | 0 (0–71.3; 55) | 0 (0–0;5) | 0.2 (0–71.3; 17) | 0 (0–51.3; 16) | 0 (0–53.6; 22) |
IgM IF, QIgM pos | %IgMCSF | 26.3 (0.2–71.3; 16) | 26.3 (0.2–71.3; 16) | n.a. (n.a.;0) | 25.8 (0.2–71.3; 9) | 17.5 (2.3–51.3; 4) | 51 (26.8–53.6; 3) |
IgM IF, > 10% | Samples | 13/62 (21%) | 13/55 (23.6%) | 0/5 (0%) | 7/17 (41.2%) | 3/16 (18.8%) | 3/22 (13.6%) |
IgM Loc, all LPs | mg/l | 0 (0–4.5;62) | 0 (0–4.5; 55) | 0 (0–0; 5) | 0 (0–4.5; 17) | 0 (0–3.5; 16) | 0 (0–2.3; 22) |
IgM Loc, QIgM pos | mg/l | 0.53 (0–4.47; 16) | 0.53 (0–4.47; 16) | n.a. | 0.6 (0–4.5; 9) | 0.1 (0–3.5; 4) | 1.3 (0.2–2.3; 3) |
IgM CSF | mg/l | 0.43 (0–9.2; 67) | 0.5 (0–9.2; 60) | 0.41 (0.21–0.6; 5) | 0.8 (0–9.2; 17) | 0.3 (0–6.89; 16) | 0.6 (0–4.2; 27) |
IgM serum | g/l | 1.04 (0.35–2.6; 69) | 1.03 (0.35–2.53; 62) | 1.63 (0.9–2.6; 5) | 1.09 (0.4–2.53; 20) | 0.83 (0.52–1.34; 17) | 1.18 (0.35–2.32; 25) |
Intrathecal IgA synthesis | |||||||
QIgA > Qlim(IgA) | Samples | 18/65 (28%) | 17/58 (29%) | 1/5 (20%) | 8/18 (44.4%) | 2/17 (11.8%) | 7/23 (30.4%) |
QIgA, all LPs | – | 1.4 (0–16.1; 64) | 1.4 (0–16.1; 57) | 0.8 (0.6–1.6; 5) | 2.62 (0–7.4; 17) | 0.83 (0–8.52; 16) | 1.39 (0–16.06; 24) |
QIgA, if positive | – | 4.2 (1.3–16.1; 18) | 5 (1.3–16.1; 17) | 1.6 (1.6–1.6; 1) | 5.08 (1.26–7.4; 8) | 7.45 (6.38–8.52; 2) | 3.06 (1.41–16.06; 7) |
IgA IF, all LPs | %IgACSF | 0 (0–82.4; 63) | 0 (0–82.4; 56) | 0 (0–3.4; 5) | 0 (0–48.9; 17) | 0 (0–63.9; 16) | 0 (0–82.4; 23) |
IgA IF, QIgA pos | %IgACSF | 17.2 (1.1–82.4; 18) | 19.5 (1.1–82.4; 17) | 3.4 (3.4–3.4; 1) | 13.7 (1.6–48.9; 8) | 43.6 (23.3–63.9; 2) | 36 (1.1–82.4; 7) |
IgA IF, > 10% | Samples | 13/63 (20.6%) | 13/56 (23.2%) | 0/5 (0%) | 6/17 (35.3%) | 2/16 (12.5%) | 5/23 (21.7%) |
IgA Loc, all LPs | mg/l | 0 (0–6.5; 63) | 0 (0–6.5; 56) | 0 (0–0.1; 5) | 0 (0–2.8; 17) | 0 (0–3.3; 16) | 0 (0–6.5; 23) |
IgA Loc, QIgA pos | mg/l | 0.8 (0–6.5; 18) | 1 (0–6.5; 17) | 0.1 (0.1–0.1; 1) | 0.8 (0.1–2.8; 8) | 2.5 (1.7–3.3; 2) | 0.6 (0–6.5; 7) |
IgA CSF | mg/l | 1.6 (0–17.4; 66) | 1.8 (0–17.4; 59) | 0.98 (0.9–2.1; 5) | 2.95 (0–17.4; 17) | 0.9 (0–7.24; 16) | 2.12 (0–10.4; 26) |
IgA serum | g/l | 1.16 (0.05–6.6; 69) | 1.16 (0.05–6.6; 62) | 1.18 (0.94–2.7; 5) | 1.22 (0.69–2.69; 20) | 0.84 (0.3–2.61; 16) | 1.21 (0.05–6.6; 26) |
Intrathecal IgA synthesis
Immunoglobulin (Ig) class patterns
Units | Total | Attack | Remission | Acute MY subgroup | Acute ON subgroup | Acute BRAIN subgroup | |
---|---|---|---|---|---|---|---|
a. Based on QIg > Qlim(Ig) | |||||||
3-class reaction | Samples | 3/63 (4.8%) | 3/56 (5.4%) | 0/5 (0%) | 2/18 (11.1%) | 0/16 (0%) | 1/22 (4.5%) |
2-class reaction | Samples | 12/63 (19%) | 12/56 (21.4%) | 0/5 (0%) | 6/18 (33.3%) | 2/16 (12.5%) | 4/22 (18.2%) |
IgG + IgM | Samples | 2/63 (3.2%) | 2/56 (3.6%) | 0/5 (0%) | |||
IgG + IgA | Samples | 4/63 (6.3%) | 4/56 (7.1%) | 0/5 (0%) | |||
IgM + IgA | Samples | 6/63 (9.5%) | 6/56 (10.7%) | 0/5 (0%) | |||
1-class reaction | Samples | 13/63 (20.6%) | 11/56 (19.6%) | 1/5 (20%) | 6/18 (33.3%) | 3/16 (18.8%) | 2/22 (9.1%) |
Only IgG | Samples | 4/63 (6.3%) | 3/56 (5.4%) | 0/5 (0%) | |||
Only IgM | Samples | 5/63 (7.9%) | 5/56 (8.9%) | 0/5 (0%) | |||
Only IgA | Samples | 4/63 (6.3%) | 3/56 (5.4%) | 1/5 (20%) | |||
b. Based on Ig-IF > 10% | |||||||
3-class reactiona | Samples | 2/63 (3.2%) | 2/56 (3.6%) | 0/5 (0%) | 1/18 (5.6%) | 0/16 (0%) | 1/22 (4.5%) |
2-class reactionb | Samples | 6/63 (9.5%) | 6/56 (10.7%) | 0/5 (0%) | 2/18 (11.1%) | 1/16 (6.3%) | 3/22 (13.6%) |
IgG + IgM | Samples | 0/63 (0%) | 0/56 (0%) | 0/5 (0%) | |||
IgG + IgA | Samples | 1/63 (1.6%) | 1/56 (1.8%) | 0/5 (0%) | |||
IgM + IgA | Samples | 5/63 (7.9%) | 5/56 (8.9%) | 0/5 (0%) | |||
1-class reaction | Samples | 13/63 (20.6%) | 13/56 (23.2%) | 0/5 (0%) | 9/18 (50%) | 3/16 (18.8%) | 1/22 (4.5%) |
Only IgG | Samples | 3/63 (4.8%) | 3/56 (5.4%) | 0/5 (0%) | |||
Only IgM | Samples | 6/63 (9.5%) | 6/56 (10.7%) | 0/5 (0%) | |||
Only IgA | Samples | 4/63 (6.3%) | 4/56 (7.1%) | 0/5 (0%) |
MRZ reaction
Units | Total cohort | |
---|---|---|
MRZ reaction (M+R, M+Z, R+Z or M+R+Z) | Patients | 0/24 (0%) |
MRZ reaction (M+R, M+Z, R+Z or M+R+Z) | Samples | 0/28 (0%) |
AI measles virus (M) | Samples | 0/25 (0%) |
AI rubella virus (R) | Samples | 0/19 (0%) |
AI varizella zoster virus (Z) | Samples | 0/28 (0%) |
Other antibody indices | ||
AI HSV | Samples | 0/21 (0%) |
AI EBV | Samples | 0/12 (0%) |
AI CMV | Samples | 0/14 (0%) |
AI B. burgdorferi, IgG | Samples | 0/27 (0%) |
AI B. burgdorferi, IgM | Samples | 1/26 (3.8%) |
Other antibody indices
Blood–CSF barrier integrity
Units | Total | Attack | Remission | Acute MY subgroup | Acute ON subgroup | Acute BRAIN subgroup | |
---|---|---|---|---|---|---|---|
Blood–CSF barrier function | |||||||
QAlb > QAlb(lim) | Samples | 36/79 (45.6%) | 36/71 (50.7%) | 0/6 (0%) | 15/23 (65.2%) | 6/21 (28.6%) | 15/27 (55.6%) |
QAlb, all LPs | – | 4 (1.8–15; 78) | 4.5 (1.8–15; 70) | 3.3 (2.6–3.7; 6) | 6 (1.8–11.5; 23) | 3.2 (1.9–11.6; 20) | 4.6 (1.9–15; 27) |
QAlb, if positive | – | 6.9 (4.52–15.04; 35) | 6.9 (4.52–15.04; 35) | 0 (0–0; 0) | 8 (4.5–11.5; 15) | 5.1 (4.6–11.6; 5) | 6.7 (4.5–15; 15) |
Alb CSF | mg/l | 186 (76.8–624; 78) | 198 (76.8–624; 70) | 131.5 (113–161; 6) | 237 (76.8–572; 23) | 143 (82–520; 19) | 198 (77–624; 28) |
Alb serum | g/l | 43.35 (30.5–53.9; 78) | 43.4 (30.5–53.9; 70) | 42.6 (36–45.3; 6) | 43.4 (32–53.8; 25) | 44 (37.3–48.5; 19) | 42.2 (30.5–53.9; 26) |
Albumin–cellular dissociation | Samples | 8/36 (22.2%) | 8/36 (22.2%) | 0/0 (0%) | 1/15 (6.7%) | 4/6 (66.7%) | 3/15 (20%) |
Combined intrathecal IgG | |||||||
synthesis and BCB disruption | Samples | 7/36 (19.4%) | 7/36 (19.4%) | 0/0 (0%) | 6/15 (40%) | 0/6 (0%) | 1/15 (6.7%) |
CSF total protein | |||||||
CSF TP, all LPs | mg/dl | 30.95 (10–97.2; 98) | 32.2 (13.4–97.2; 87) | 22.1 (10–56.6; 9) | 42.1 (14–89; 28) | 25.6 (13.4–64; 23) | 32.6 (14.2–97.2; 36) |
CSF TP, > 100 mg/dl | Samples | 0/98 (0%) | 0/87 (0%) | 0/9 (0%) | 0/28 (0%) | 0/23 (0%) | 0/0 (0%) |
CSF TP, elevated (> 45 mg/dl) | Samples | 22/98 (22.4%) | 21/87 (24.1%) | 1/9 (11.1%) | 10/27 (37%) | 1/25 (4%) | 10/35 (28.6%) |
CSF TP, if elevated (> 45 mg/dl) | mg/dl | 58.3 (46.3–97.2; 22) | 60 (46.3–97.2; 21) | 56.6 (56.6–56.6; 1) | 57 (46.3–89; 10) | 64 (64–64; 1) | 57 (49–97.2; 10) |
CSF TP, elevated (age–adapteda) | Samples | 59/98 (60.2%) | 54/87 (62.1%) | 3/9 (33.3%) | 55/85 (64.7%) | 2/11 (18.2%) | 52/77 (67.5%) |
CSF TP, if elevated (age-adapteda) | mg/dl | 41 (26.1–97.2; 59) | 42.6 (26.1–97.2; 54) | 40 (31.7–56.6; 3) | 42 (26.1–97.2; 55) | 38.7 (28.4–49; 2) | 42.6 (26.1–97.2; 52) |
CSF l-lactate | |||||||
CSF l-lactate, elevated | samples | 22/72 (30.6%) | 20/66 (30.3%) | 2/6 (33.3%) | 10/22 (45.5%) | 4/21 (19%) | 6/23 (26.1%) |
CSF l-lactate, all LPs | mmol/l | 1.6 (0.9–2.83; 70) | 1.6 (0.9–2.83; 64) | 1.7 (1–2.11; 6) | 1.74 (1–2.6; 22) | 1.5 (0.97–2.56; 19) | 1.57 (0.9–2.83 ;23) |
CSF lactate, if elevated | mmol/l | 2 (1.8–2.83; 22) | 2 (1.8–2.83; 20) | 2.01 (1.9–2.11; 2) | 2.04 (1.38–2.6; 6) | 1.53 (1.53–1.53; 1) | 1.57 (1.1–2.83; 7) |
CSF l-lactate, > 3 mmol/l | samples | 0/70 (0%) | 0/64 (0%) | 0/6 (0%) | 0/22 (0%) | 0/19 (0%) | 0/23 (0%) |
CSF total protein
CSF l-lactate
First vs. follow-up LP
Units | First LP ever | Follow-up LPs, first LP/event | |
---|---|---|---|
Pleocytosis, all acute attacks | Samples | 41/70 (58.6%) | 4/11 (36.4%) |
Pleocytosis, acute MY | Samples | 21/25 (84%) | 1/2 (50%) |
Pleocytosis, acute ON | Samples | 4/21 (19%) | 1/4 (25%) |
Pleocytosis, acute BRAIN | Samples | 16/24 (66.7%) | 2/5 (40%) |
OCB, all acute attacks | Samples | 8/67 (11.9%) | 1/12 (8.3%) |
OCB, acute MY | Samples | 6/25 (24%) | 1/2 (50%)a |
OCB, acute ON | Samples | 0/21 (0%) | 0/5 (0%) |
OCB, acute BRAIN | Samples | 2/21 (9.5%) | 0/5 (0%) |
IgG-IF > 10%, all acute attacks | Samples | 4/53 (7.5%) | 6/12 (50%) |
IgG-IF > 10%, acute MY | Samples | 2/20 (10%) | 1/1 (100%) |
IgG-IF > 10%, acute ON | Samples | 0/18 (0%) | 0/1 (0%) |
IgG-IF > 10%, acute BRAIN | Samples | 2/15 (13.3%) | 0/5 (0%) |
QAlb > Qlim(Alb), all acute attacks | Samples | 28/56 (50%) | 3/8 (37.5%) |
QAlb > Qlim(Alb), acute MY | Samples | 14/21 (66.7%) | 0/1 (0%) |
QAlb > Qlim(Alb), acute ON | Samples | 3/18 (16.7%) | 2/2 (100%) |
QAlb > Qlim(Alb), acute BRAIN | Samples | 11/17 (64.7%) | 1/5 (20%) |
CSF TP elevated, all acute attacks | Samples | 16/66 (24.2%) | 2/11 (18.2%) |
CSF TP elevated, acute MY | Samples | 9/23 (39.1%) | 1/2 (50%) |
CSF TP elevated, acute ON | Samples | 1/20 (5%) | 0/4 (0%) |
CSF TP elevated, acute BRAIN | Samples | 6/23 (26.1%) | 1/5 (20%) |
CSF l-lactate elevated, all acute attacks | Samples | 17/49 (34.7%) | 2/10 (20%) |
CSF l-lactate elevated, acute MY | Samples | 9/18 (50%) | 1/2 (50%) |
CSF l-lactate elevated, acute ON | Samples | 2/16 (12.5%) | 1/4 (25%) |
CSF l-lactate elevated, acute BRAIN | Samples | 6/15 (40%) | 0/4 (0%) |
Time since attack onset, acute LPs | Days | 2 (0–33) | 4.5 (0–40) |
Attack severity
Units | Severe attacks | Mild/moderate attacks | p value | |
---|---|---|---|---|
WCC, all | Cells/μl | 28.5 (0–256; 64) | 3 (0–179; 26) | 0.0000002 |
WCC, elevated | Samples | 47/64 (73.4%) | 6/26 (23.1%) | 0.00001 |
WCC, if elevated | Cells/μl | 48 (9–256; 47) | 12 (6–179;6) | 0.016 |
Neutrophils, all LPs | Samples | 16/31 (51.6%) | 4/12 (33.3%) | n.s. |
OCB, pattern 2 or 3 | Samples | 10/58 (17.2%) | 1/27 (3.7%) | n.s. |
Link index | Samples | 9/45 (20%) | 1/22 (4.5%) | n.s. |
QIgG, all | Ratio | 2.7 (0.8–8.1; 47) | 1.7 (0.8–8.2;23) | 0.004 |
QIgG, elevated | Samples | 11/46 (23.9%) | 2/23 (8.7%) | n.s. |
QIgG, if elevated | Ratio | 2.4 (1.5–7; 11) | 2.1 (1.7–2.5; 2) | n.s. |
QAlb, all | Ratio | 5.2 (1.8–15; 48) | 3.3 (1.9–11.6; 23) | 0.004 |
Qalb, elevated | Samples | 29/48 (60.4%) | 7/23 (30.4%) | 0.023 |
QAlb, if elevated | Ratio | 7 (4.5–15; 29) | 5.3 (4.6–11.6; 7) | n.s. |
CSF TP, all | mg/dl | 36.5 (14–97.2; 63) | 26.1 (13.4–64; 25) | 0.008 |
CSF TP, elevated | Samples | 19/61 (31.1%) | 2/25 (8%) | 0.027 |
CSF TP, if elevated | mg/dl | 60 (46.3–97.2; 19) | 59 (54–64; 2) | n.s. |
CSF TP, >100 mg/dl | Samples | 0/70 (0%) | 0/26 (0%) | n.s. |
CSF l-lactate, all | mmol/l | 1.7 (0.9–2.8; 44) | 1.5 (1–2.6; 22) | n.s. |
CSF l-lactate, elevated | Samples | 16/44 (36.4%) | 4/22 (18.2%) | n.s. |
CSF l-lactate, if elevated | mmol/l | 2 (1.8–2.8; 16) | 2.3 (1.9–2.6; 4) | n.s. |
CSF l-lactate, >3 mmol/l | Samples | 0/48 (0%) | 0/22 (0%) | n.s. |
LETM vs. non-longitudinally extensive transverse myelitis
Bilateral vs. unilateral ON
Disease course
1st LP/event | Units | Monophasic | Relapsing |
---|---|---|---|
Pleocytosis, acute attacks | Samples | 26/41 (63.4%) | 19/40 (47.5%)a |
Pleocytosis, acute MY | Samples | 14/16 (87.5%) | 8/11 (72.7%) |
Pleocytosis, acute ON | Samples | 3/12 (25%) | 2/13 (15.4%) |
Pleocytosis, acute BRAIN | Samples | 9/13 (69.2%) | 9/16 (56.3%) |
OCB, acute attacks | Samples | 5/39 (12.8%) | 4/40 (10%)a |
OCB, acute MY | Samples | 4/17 (23.5%) | 3/10 (30%) |
OCB, acute ON | Samples | 0/12 (0%) | 0/14 (0%) |
OCB, acute BRAIN | Samples | 1/10 (10%) | 1/16 (6.3%) |
IgG-IF > 10%, acute attacks | Samples | 3/36 (8.3%) | 2/24 (8.3%)a |
IgG-IF > 10%, acute MY | Samples | 2/16 (12.5%) | 1/5 (20%) |
IgG-IF > 10%, acute ON | Samples | 0/12 (0%) | 0/7 (0%) |
IgG-IF > 10%, acute BRAIN | Samples | 1/8 (12.5%) | 1/12 (8.3%) |
QAlb > Qlim(Alb), acute attacks | Samples | 18/36 (50%) | 13/28 (46.4%)a |
QAlb > Qlim(Alb), acute MY | Samples | 11/16 (68.8%) | 3/6 (50%) |
QAlb > Qlim(Alb), acute ON | Samples | 3/12 (25%) | 2/8 (25%) |
QAlb > Qlim(Alb), acute BRAIN | Samples | 4/8 (50%) | 8/14 (57.1%) |
CSF TP elevated, acute attacks | Samples | 10/39 (25.6%) | 8/38 (21.1%)a |
CSF TP elevated, acute MY | samples | 7/15 (46.7%) | 3/10 (30%) |
CSF TP elevated, acute ON | Samples | 1/12 (8.3%) | 0/12 (0%) |
CSF TP elevated, acute BRAIN | Samples | 2/12 (16.7%) | 5/16 (31.3%) |
CSF l-lactate elevated, acute attacks | Samples | 14/33 (42.4%) | 5/26 (19.2%)a |
CSF l-lactate elevated, acute MY | Samples | 8/14 (57.1%) | 2/6 (33.3%) |
CSF l-lactate elevated, acute ON | Samples | 2/10 (20%) | 1/10 (10%) |
CSF l-lactate elevated, acute BRAIN | Samples | 4/9 (44.4%) | 2/10 (20%) |
Time since attack onset, acute LPs | Days | 2 (0-33) | 2 (0-40) |
Treatment status
OCB-positive vs. OCB-negative MOG-EM
Acute attacks vs. remission
Units | Attack, all, first LP/event | Remission, all, last LP/event | p values | |
---|---|---|---|---|
Pleocytosis | Samples | 45/81 (55.6%) | 3/11 (27.3%) | p = n.s. |
WCC | Cells/μl | 13 (0–256;81) | 4 (0–35;11) | p < 0.04 |
WCC > 100/μl | Samples | 10/81 (12.3%) | 0/11 (0%) | p = n.s. |
OCB | Samples | 9/79 (11.4%) | 0/8 (0%) | p = n.s. |
QIgG > Qlim(IgG) | Samples | 12/62 (19.4%) | 0/7 (0%) | p = n.s. |
QIgG | Ratio | 2.35 (0.83–8.16; 61) | 1.63 (1.32–1.74; 6) | p < 0.03 |
IgG–IF > 10% | Samples | 5/60 (8.3%) | 0/6 (0%) | p = n.s. |
QIgM > Qlim(IgM) | Samples | 15/51 (29.4%) | 0/6 (0%) | p = n.s. |
QIgM | Ratio | 0.43 (0–7.33; 50) | 0.23 (0.13–0.46; 5) | p = n.s. |
QIgA > Qlim(IgA) | Samples | 15/52 (28.8%) | 1/5 (20%) | p = n.s. |
QIgA | Ratio | 1.42 (0–16.06; 51) | 0.83 (0.64–1.6; 5) | p = n.s. |
QAlb > Qlim(Alb) | Samples | 31/64 (48.4%) | 0/6 (0%) | p < 0.04 |
QAlb | Ratio | 4.52 (1.79–11.73; 63) | 3.29 (2.63–3.66; 6) | p = n.s. |
CSF TP elevated | Samples | 18/77 (23.4%) | 1/9 (11.1%) | p = n.s. |
CSF TP concentrations | mg/dl | 31 (13.4–97.2; 77) | 22.1 (10–56.6; 9) | p = n.s. |
CSF TP > 100 mg/dl | Samples | 0/79 (0%) | 0/9 (0%) | p = n.s. |
CSF l-lactate elevated | Samples | 19/59 (32.2%) | 2/6 (33.3%) | p = n.s. |
CSF l-lactate concentrations | mg/dl | 1.6 (0.9–2.83; 57) | 1.7 (1–2.11; 6) | p = n.s. |
CSF l-lactate > 3 mmol/l | Samples | 0/59 (0%) | 0/6 (0%) | p = n.s. |
Time since attack onset | Days | 2 (0–40; 84) | 48 (48–3595; 11) |