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HelpTest Code LAB5121 Multiple Sclerosis (MS) Profile, Serum and Spinal Fluid
Specimen Required
Both serum and spinal fluid are required. Spinal fluid must be obtained within 1 week of serum collection.
Specimen Type: Spinal fluid
Container/Tube: Sterile vial
Specimen Volume: 1 mL
Collection Instructions: Label specimen as spinal fluid.
Specimen Type: Serum
Collection Container/Tube:
Preferred: Serum gel
Acceptable: Red top
Submission Container/Tube: Plastic vial
Specimen Volume: 1 mL
Collection Instructions:
1. Centrifuge and aliquot serum into a plastic vial within 2 hours of collection.
2. Label specimen as serum.
Useful For
Diagnosing multiple sclerosis, especially helpful in patients with equivocal clinical or radiological findings
Profile Information
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| KCSFP | Kappa Free Light Chain, CSF | Yes, (KCSF) | Yes |
| XSRM | Additional sample for reflex OLIGS | No | Yes |
Reflex Tests
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| OLIGS | Serum Bands | Yes, (Order OLIG, submit CSF and Serum) | No |
| OLIGC | CSF Bands | Yes, (Order OLIG, submit CSF and Serum) | No |
Testing Algorithm
Kappa free light-chain testing will be performed by nephelometry on cerebral spinal fluid (CSF) samples. When kappa free light-chain testing indicates either borderline or positive results (≥0.0600 mg/dL), the oligoclonal banding tests will be performed at an additional charge. If the time of testing exceeds the specimen stability for oligoclonal banding tests, only kappa free light-chain testing will be performed. Kappa free light-chain testing will only be performed up to specimen stability.
Reporting Name
Multiple Sclerosis ProfileSpecimen Type
CSFSerum
Specimen Minimum Volume
Serum, Spinal fluid: 0.5 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| CSF | Frozen (preferred) | 14 days | |
| Refrigerated | 72 hours | ||
| Ambient | 24 hours | ||
| Serum | Frozen (preferred) | 14 days | |
| Ambient | 14 days | ||
| Refrigerated | 14 days |
Reject Due To
| Gross hemolysis | Reject |
| Gross lipemia | OK |
| Gross icterus | OK |
Reference Values
KAPPA FREE LIGHT CHAIN
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
OLIGOCLONAL BANDS:
<2 bands
Supportive Data
In a cohort of 1307 patients, where 159 had demyelinating disease, the Mayo Clinic oligoclonal banding test had a clinical sensitivity of 74% and clinical specificity of 89%, area under the ROC curve of 0.813, when 2 or more unique cerebrospinal fluid (CSF) bands are used as a cutoff for positive. This kappa free light chain test, when considered positive at a concentration greater than or equal to 0.1000 mg/dL as a medical decision point, has a sensitivity of 70% with a specificity of 87%. The differences between the 2 tests are not statistically significant and the 2 tests show comparable performance with shorter turn-around-time for results and an objective quantitative result.
This panel combines the ease of use and interpretation of the quantitative measurement of kappa free light chains in CSF and allies it to the traditional interpretation of oligoclonal bands for optimized efficiency in laboratory testing for demyelinating diseases and improved test utilization.
Day(s) Performed
Monday through Friday
Report Available
3 to 5 daysSpecimen Retention Time
14 daysPerforming Laboratory
Mayo Clinic Laboratories in Rochester
CPT Code Information
83521
83916 x2 (if appropriate)
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| MSP3 | Multiple Sclerosis Profile | 100757-4 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| KCSFP | Kappa Free Light Chain, CSF | 48774-4 |
| XSRM | Additional sample for Reflex OLIGS | No LOINC Needed |
Forms
If not ordering electronically, complete, print, and send a Neurology Specialty Testing Client Test Request (T732) with the specimen.