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Int. J. Mol. Sci. 2017, 18(10), 2061; doi:10.3390/ijms18102061

Clinically Isolated Syndrome According to McDonald 2010: Intrathecal IgG Synthesis Still Predictive for Conversion to Multiple Sclerosis

1
Clinical Neuroimmunology and Neurochemistry, Department of Neurology, Hannover Medical School, 30625 Hannover, Germany
2
Department of Diagnostic and Interventional Neuroradiology, Hannover Medical School, 30625 Hannover, Germany
3
Department of Neurology, University Clinic Essen, 45147 Essen, Germany
*
Author to whom correspondence should be addressed.
Received: 30 August 2017 / Revised: 20 September 2017 / Accepted: 22 September 2017 / Published: 27 September 2017
(This article belongs to the Special Issue Advances in Multiple Sclerosis 2017)
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Abstract

While the revised McDonald criteria of 2010 allow for the diagnosis of multiple sclerosis (MS) in an earlier stage, there is still a need to identify the risk factors for conversion to MS in patients with clinically isolated syndrome (CIS). Since the latest McDonald criteria were established, the prognostic role of cerebrospinal fluid (CSF) and visual evoked potentials (VEP) in CIS patients is still poorly defined. We conducted a monocentric investigation including patients with CIS in the time from 2010 to 2015. Follow-ups of 120 patients revealed that 42% converted to MS. CIS patients with positive oligoclonal bands (OCB) were more than twice as likely to convert to MS as OCB negative patients (hazard ratio = 2.6). The probability to develop MS was even higher when a quantitative intrathecal IgG synthesis was detected (hazard ratio = 3.8). In patients with OCB, VEP did not add further information concerning the conversion rate to MS. In patients with optic neuritis and negative OCB, a significantly higher rate converted to MS when VEP were delayed. In conclusion, the detection of an intrathecal IgG synthesis increases the conversion probability to MS. Pathological VEP can help to predict the conversion rate to MS in patients with optic neuritis without an intrathecal IgG synthesis. View Full-Text
Keywords: clinically isolated syndrome; multiple sclerosis; OCB; CSF clinically isolated syndrome; multiple sclerosis; OCB; CSF
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Schwenkenbecher, P.; Sarikidi, A.; Bönig, L.; Wurster, U.; Bronzlik, P.; Sühs, K.-W.; Pul, R.; Stangel, M.; Skripuletz, T. Clinically Isolated Syndrome According to McDonald 2010: Intrathecal IgG Synthesis Still Predictive for Conversion to Multiple Sclerosis. Int. J. Mol. Sci. 2017, 18, 2061.

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