Oligoclonal Bands (Blood & CSF)

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Auckland Te Toka Tumai

Test Guide

Oligoclonal Bands (Blood & CSF)

Testing Laboratory

Auckland Te Toka Tumai | Auckland Hospital

Department

Chemical Pathology

Delphic Registration Code (Alpha Code)

CEPG

Test Code (Numeric Code)

7261

Laboratory Handling

Phlebotomy

Serum

Transport

Ambient

Registration

CSF and Serum samples require separate barcode numbers. CSF requires CF and US suffix. Serum requires PG/PA/PH/PI/SP with US suffix

Laboratory

LabPlus Immunochemistry

Test Adds Requirement

Samples are stored at -20°C for 1 month

Sample Stability

CSF IgG: 1 day at 15-25°C, 7 days at 2-8°C. CSF Albumin: 3 days at 2-8°C, 6 months at -20°C. Isoelectric focusing: CSF and serum samples are stable at 2-8°C for 7 days and at -20°C for 1 month.

Associated Tests

IgG (Blood)

Synonyms

Oligoclonal bands
CSF IgG protein analysis
CSF IgG oligoclonal bands
Paired serum for oligoclonal bands
CSF IgG Isoelectric focusing

Turnaround Time

2 weeks

Test is only performed during the week. If expedited testing is required due to clinical needs, please contact the on-call chemical pathologist via LabLink or email ChemicalPathologist@adhb.govt.nz

Specimen Type

CSF
Serum

Specimen Requirements

Tube/Container Type:

Preferred

CSF sterile tubes (Routine Analysis)
Plain (Red Top)

Acceptable

SST II (Gold Cap)

Preferred Sample Volume (ml)

Minimum Sample Volume (ml)

Paediatric Specimen Requirements

Tube/Container Type:

Preferred

CSF sterile tubes (Routine Analysis)
Plain (Red Top)

Acceptable

SST II (Gold Cap)

Preferred Sample Volume (ml)

0.5

Minimum Sample Volume (ml)

0.25

Pre-testing Requirements

Both CSF and serum specimens are required to detect intrathecal IgG production. In order to minimise false positive tests, both CSF and serum should be collected on the same day (though a gap between specimens of up to 5 days may be accepted).

To minimise delay, on the lab request form we recommend you write: "CSF for oligoclonal bands" under the CSF section and "Paired serum for CSF IgG oligoclonal band test" at the "Other tests" section . Requests that do not satisfy sample requirements may be delayed.

Additional Specimen Information

Serum samples for the following tests on the same request form require separate barcode numbers :
Alkaline Phosphatase Isoenzymes
Cerebrospinal fluid protein analysis (serum)
Serum Protein Electrophoresis
Lipoprotein Electrophoresis
Cryoglobulin

Diagnostic Use

This test may be used to support the diagnosis of inflammation of the central nervous system. It can be used as evidence of ‘dissemination in time’ as part of the 2024 McDonald Criteria for the diagnosis of multiple sclerosis. Intrathecal IgG synthesis is also seen in other conditions including Guillane-Barre syndrome and neurosyphilis.

Intrathecal IgG synthesis is assessed by:

Measurement of CSF and serum IgG and albumin, and calculation of derived indices.
Detection of IgG oligoclonal bands by isoelectric focussing and immunofixation.

Both the above tests will be performed if CSF protein analysis is requested.

Interpretation

The presence of oligoclonal bands in the CSF that are not matched in the serum supports a diagnosis of multiple sclerosis, though other neuro-inflammatory or infectious processes may produce a similar pattern.

A single unmatched band in the CSF is less typical of multiple sclerosis and other diagnosis should be considered.

No unmatched oligoclonal bands weighs against a multiple sclerosis diagnosis, though this test is not 100% sensitive.

Reference Intervals

CSF albumin : < 250 mg/L

CSF IgG : < 42 mg/L

Serum IgG : age dependent

CSF/serum albumin index: Normal < 9

CSF/serum albumin index = CSF albumin (mg/L) / serum albumin (g/L)

This is an index of blood-brain barrier (BBB) integrity, adjusted for the serum albumin concentration. This index is increased in BBB dysfunction.

CSF IgG/albumin ratio: Normal < 0.27

CSF IgG/albumin ratio = CSF IgG (mg/L) / CSF albumin (mg/L)

This is an index of local IgG production, adjusted for leakage of IgG from the plasma due to BBB dysfunction. (This ratio is used if a serum sample is not available.) This ratio is increased when local CNS IgG synthesis is occurring.

CSF IgG index: Normal < 0.7

CSF IgG index = (CSF IgG x serum albumin) / (CSF albumin x serum IgG)

This is the best index of local IgG production, adjusted both for leakage of IgG due to BBB dysfunction and for serum albumin and IgG concentrations. This index is increased in more than 80% of cases of multiple sclerosis). It is not specific for multiple sclerosis, and is increased in any condition where there is local CNS IgG synthesis.

NOTE: All of the above parameters may be falsely elevated if the measurements were performed on a traumatic CSF tap.

Test Method

Isoelectric focusing (Sebia kit)

Limitations / Interference

This test is not 100% sensitive or specific for multiple sclerosis. There is a degree of subjectivity in the reading and reporting of the result.

Uncertainty of Measurement

CSF IgG: 6% CSF Albumin: 6%

Last updated: 13/05/2026

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A B C D E F G H I J K L M N O P Q R S T U V W X Y Z #

Overview

Testing Laboratory

Department

Delphic Registration Code (Alpha Code)

Test Code (Numeric Code)

Laboratory Handling

Phlebotomy

Transport

Registration

Laboratory

Test Adds Requirement

Sample Stability

Associated Tests

Synonyms

Turnaround Time

Specimen

Specimen Type

Specimen Requirements

Tube/Container Type:

Preferred

Acceptable

Preferred Sample Volume (ml)

Minimum Sample Volume (ml)

Paediatric Specimen Requirements

Tube/Container Type:

Preferred

Acceptable

Preferred Sample Volume (ml)

Minimum Sample Volume (ml)

Pre-testing Requirements

Additional Specimen Information

Referral

Aliquot Instructions

Sample Type

Minimum Volume (ml)

Transport to Lab

Additional Referral/Aliquot Information

Clinical Information/Test Method

Diagnostic Use

Interpretation

Reference Intervals

Test Method

Limitations / Interference

Uncertainty of Measurement

Contact Information

Contact Information

Enquiry Form

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