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Oligoclonal bands
  1. Mark D Willis1,
  2. Karim L Kreft1,
  3. Bethan Dancey2
  1. 1 Helen Durham Centre for Neuroinflammatory Disease, Department of Neurology, University Hospital of Wales, Cardiff, UK
  2. 2 Department of Clinical Immunology & Allergy, University Hospital of Wales, Cardiff, UK
  1. Correspondence to Dr Mark D Willis; willismd{at}cardiff.ac.uk

Abstract

Oligoclonal bands (OCBs) represent the presence of intrathecal immunoglobulin G (IgG) as detected by isoelectric focusing and immunofixation. Cerebrospinal fluid (CSF) analysed alongside a paired serum sample gives five different immunofixation patterns. These are: type 1—the normal physiological state with no intrathecal IgG synthesis; type 2—evidence for intrathecal IgG synthesis, with CSF-restricted OCBs; type 3—evidence for intrathecal IgG synthesis, with CSF-restricted OCBs, but with additional, identical bands in the CSF and serum; type 4—absence of intrathecal IgG synthesis, but with identical OCBs in CSF and serum; and type 5—absence of intrathecal IgG synthesis, with a monoclonal band in CSF and serum. Analysis of these patterns can help to diagnose a range of neurological conditions, including multiple sclerosis. However, it is important to interpret OCB results alongside other CSF tests and their clinical context.

  • neuroimmunology
  • multiple sclerosis

Data availability statement

No data are available. Not applicable.

https://doi.org/10.1136/pn-2023-003814

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    Data availability statement

    No data are available. Not applicable.

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    Footnotes

    • Contributors MW wrote and edited the manuscript. KK and BD edited the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Commissioned. Externally peer reviewed by Wallace Brownlee, London, UK.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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