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Test Code KCSFP Immunoglobulin Kappa Free Light Chain, Spinal Fluid


Ordering Guidance


For evaluation of multiple sclerosis, the following are also available as individually orderable tests:

-SFIG / Cerebrospinal Fluid IgG Index Profile, Serum and Spinal Fluid

-OLIG / Oligoclonal Banding, Serum and Spinal Fluid



Specimen Required


Only orderable as part of a profile. For more information see MSP3 / Multiple Sclerosis (MS) Cascade, Serum and Spinal Fluid.

 

Specimen Type: Spinal fluid (CSF)

Container/Tube: Sterile vial

Specimen Volume: 1 mL

Collection Instructions:

1. Submit CSF from collection vial number 4 (preferred); vial number 1, 3, and 2 are also acceptable (in this order).

2. Label specimen as CSF.


Useful For

Diagnosis of multiple sclerosis and other demyelinating conditions

Reporting Name

Kappa Free Light Chain, CSF

Specimen Type

CSF

Specimen Minimum Volume

0.5 mL

Specimen Stability Information

Specimen Type Temperature Time
CSF Frozen (preferred) 28 days
  Refrigerated  72 hours
  Ambient  24 hours

Reject Due To

Gross hemolysis Reject
Gross icterus OK

Reference Values

Only orderable as part of a profile. For more information see MSP3 / Multiple Sclerosis (MS) Cascade, Serum and Spinal Fluid.

 

Medical decision point: 0.1000 mg/dL

Positive: ≥0.1000 mg/dL

Borderline: 0.0600 mg/dL-0.0999 mg/dL

Negative: <0.0600 mg/dL

Supportive Data

The McDonald revised criteria states that diagnosis of demyelinating disease can be assumed when 2 unique bands are found in cerebrospinal fluid (CSF) using the oligoclonal banding (OLIG) test.(1)

 

Based on a published Mayo Clinic study with 325 subjects, this test alone demonstrates comparable performance to OLIG along with increased sensitivity for demyelinating diseases.(2)

 

After this initial study, a second larger cohort was used to validate kappa free light chain (FLC) results with a larger number of samples.(3) This study found that in comparison to the current standards of detecting 2 unique CSF bands, kappa FLC results at a value greater than or equal to 0.1000 mg/dL showed comparable sensitivity and specificity to OLIG to support diagnosis of multiple sclerosis.

 

Using the MSP / Multiple Sclerosis (MS) Cascade, Serum and Spinal Fluid and the reflex approach, Mayo Clinic studies with over 1300 subjects report 75.5% sensitivity and 86% specificity to identify demyelinating disease from non-demyelinating disease.

Day(s) Performed

Monday through Friday

Report Available

1 to 3 days

Performing Laboratory

Mayo Clinic Laboratories in Rochester

CPT Code Information

83521

LOINC Code Information

Test ID Test Order Name Order LOINC Value
KCSFP Kappa Free Light Chain, CSF 48774-4

 

Result ID Test Result Name Result LOINC Value
KCSFP Kappa Free Light Chain, CSF 48774-4