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

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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.

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