Combined analysis of free kappa chains and central vein sign increases the specificity of multiple sclerosis diagnosis

Abstract

Objective: to determine the sensitivity and specificity of simultaneous analysis of the central vein sign (CVS) and the concentration of free kappa chains (FKC) in cerebrospinal fluid (CSF) in the diagnosis of multiple sclerosis (MS).Material and methods. Eighty patients participated in the study. The main group comprised 54 patients who had been diagnosed with MS according to the 2017 McDonald criteria. The comparison group comprised 26 patients with other diseases of the central nervous system. An enzyme-linked immunosorbent assay was used to determine the concentration of FKC in the CSF. MRI of the brain was performed in all patients. The total and relative number of lesions with CVS were calculated.Results. An increased level of FKC in the CSF and a higher frequency of lesions with CVS were found in the group of MS patients compared to the control group (p<0.001). The sensitivity of the integrated laboratory and radiological model was 96.3 %, the specificity – 96.2 %.Conclusion. A comprehensive laboratory and radiological model based on the simultaneous analysis of FKC and CVS has high sensitivity and specificity parameters for the diagnosis of MS. This paves the way for the further inclusion of these two markers in the criteria for the diagnosis of the disease.

Keywords

• multiple sclerosis
• central vein symptom
• kappa chains
• macdonald criteria