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Test ID CASF IgG/Albumin Ratio, Spinal Fluid

Useful For

The cerebrospinal fluid (CSF) index is useful in the diagnosis of individuals with multiple sclerosis. In the absence of a paired CSF and serum specimen, the CSF IgG/albumin ratio can be assessed.

 

The index is independent of the activity of the demyelinating process.

Method Name

Nephelometry

Reporting Name

IgG/Albumin Ratio, CSF

Specimen Type

CSF

Collection Container/Tube: Sterile vial

Collection Container/Tube: Plastic vial

Specimen Volume: 1 mL

Specimen Minimum Volume

0.5 mL

Specimen Stability Information

Specimen Type Temperature Time
CSF Refrigerated (preferred) 14 days
  Ambient  14 days
  Frozen  14 days

Clinical Information

Elevation of IgG levels in the cerebrospinal fluid (CSF) of patients with inflammatory diseases of the central nervous system (CNS) (multiple sclerosis, neurosyphilis, acute inflammatory polyradiculoneuropathy, subacute sclerosing panencephalitis) is due to local (CNS) synthesis of IgG.

 

The two most commonly used diagnostic laboratory tests for multiple sclerosis are CSF index and oligoclonal banding. The CSF index is the CSF IgG to CSF albumin ratio compared to the serum IgG to serum albumin ratio. The CSF index is therefore an indicator of the relative amount of CSF IgG compared to serum and any increase in the index is a reflection of IgG production in the central nervous system.  The IgG synthesis rate is a mathematical manipulation of the CSF index data and can also be used as a marker for CNS inflammatory diseases.

Reference Values

CSF IgG: 0.0-8.1 mg/dL

CSF albumin: 0.0-27.0 mg/dL

CSF IgG/albumin: 0.00-0.21

Cautions

The cerebrospinal fluid (CSF) index can be elevated in other inflammatory demyelinating diseases such as neurosyphillis, acute inflammatory polyradiculoneuropathy, and subacute sclerosing panencephalitis. Oligoclonal banding in CSF is slightly more sensitive (85%) than the CSF index. The use of CSF index plus oligoclonal banding has been reported to increase the sensitivity to over 90%.

Day(s) Performed

Monday through Saturday; 2 p.m.

Report Available

Same day/1 day

Performing Laboratory

Mayo Medical Laboratories in Rochester

Test Classification

This test has been cleared or approved by the U.S. Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.

CPT Code Information

82042-Albumin

82784-IgG

NY State Approved

Yes