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Test Code OLIG Oligoclonal Banding, Serum and Spinal Fluid

Performing Laboratory

Mayo Medical Laboratories in Rochester

Reporting Name

Oligoclonal Banding

Specimen Type


Specimen Required

Serum and spinal fluid are required. Spinal fluid must be obtained within 1 week of serum draw.


Specimen Type: Serum


Preferred: Red top

Acceptable: Serum gel

Specimen Volume: 0.5 mL

Collection Instructions: Label specimen as serum.


Specimen Type: Spinal fluid

Container/Tube: Sterile vial

Specimen Volume: 0.5 mL

Collection Instructions: Label specimen as spinal fluid.

Reject Due To


Mild OK; Gross OK


Mild OK; Gross OK


Mild OK; Gross OK



Specimen Stability Information

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

Specimen Minimum Volume

Serum: 0.4 mL/Spinal Fluid: 0.4 mL

Day(s) and Time(s) Performed

Monday through Saturday; 7 a.m.-12 p.m.

Specimen Retention Time

14 days

Analytic Time

2 days

Reference Values

CSF Olig Bands Interpretation: <4 bands

Useful For

Diagnosis of multiple sclerosis; especially useful in patients with equivocal clinical presentation and radiological findings

Method Name

Isoelectric Focusing (IEF) with IgG Immunoblot Detection

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

83916-Spinal fluid


LOINC Code Information

Test ID Test Order Name Order LOINC Value
OLIG Oligoclonal Banding In Process


Result ID Test Result Name Result LOINC Value
8017 CSF Bands 56764-4
2783 Serum Bands 56974-9
23611 CSF Olig Bands Interpretation 49852-7

Clinical Information

The diagnosis of multiple sclerosis (MS) is dependent on clinical, radiological, and laboratory findings. The detection of increased intrathecal immunoglobulin (Ig) synthesis is the basis for current diagnostic laboratory tests for MS. These tests include the cerebrospinal fluid (CSF) IgG index and CSF oligoclonal band (OCB) detection. Abnormal CSF IgG indexes and OCB patterns have been reported in 70% to 80% of MS patients. At least 1 of these tests has been reported to be positive in 90% of MS patients when both test are performed.


Newer methodologies for OCB detection have been reported to be more sensitive, with sensitivities of 90% to 95% in CSF from MS patients.


Increased intrathecal Ig synthesis may occur in other inflammatory CSF diseases and, therefore, this assay is not specific for MS (specificity = 95%).


A finding of 4 or more cerebrospinal fluid (CSF)-specific bands (ie, bands that are present in CSF but are absent in serum) is consistent with multiple sclerosis.


The presence of oligoclonal band is unrelated to disease activity.


These tests are not specific for multiple sclerosis.

Clinical Reference

1. Andersson M, Alvarez-Cermeno J, Bernardi G, et al: Cerebrospinal fluid in the diagnosis of multiple sclerosis: a consensus report. J Neurol Neurosurg Psychiatry 1994;57:897-902

2. Fortini AS, Sanders EL, Weinshenker BG, Katzmann JA: Cerebrospinal fluid oligoclonal bands in the diagnosis of multiple sclerosis, isoelectric focusing with the IgG immunoblotting compared with high resolution agarose gel electrophoresis and cerebrospinal fluid IgG index. Am J Clin Pathol 2003:120:672-675

Method Description

The oligoclonal band (OCB) assay requires paired cerebrospinal fluid (CSF) and serum samples. Unconcentrated CSF and diluted serum are electrophoresed by isoelectric focusing. The separated immunoglobulin (Ig) are visualized by an IgG immunoblot, and OCBs that are present in the CSF and not in the serum are reported. The assay uses reagents from Helena Laboratories. (Keir G, Luxton RW, Thompson EJ: Isoelectric focusing of cerebrospinal fluid immunoglobulins G: an annotated update. Ann Clin Biochem 1990;27:436-443)

Profile Information

Test ID Reporting Name Available Separately Always Performed
OLIGS Serum Bands No Yes
OLIGC CSF Bands No Yes

Supportive Data

In early 2003 we compared the isoelectric focusing (IEF) assay to our previous high-resolution agarose assay as well as the cerebrospinal fluid (CSF) IgG index. The IEF assay requires a smaller volume of CSF and is easier to interpret than the agarose assay. Concordant normal specimens usually had zero bands by IEF but 1 band by agarose. The concordant positive specimens had an average of 11 bands by IEF and 2 bands on agarose.


Among 19 cases of definite multiple sclerosis (MS), the IEF oligoclonal band (OCB) assay had a sensitivity of 95%, the agarose assay had a sensitivity of 63%, and the CSF index had a sensitivity of 74%. Among 57 consecutive non-MS cases, the IEF OCB assay had a specificity of 95% and agarose and CSF index assays had a specificity of 97%. These data demonstrated a 32% increase in sensitivity and a 2% decrease in specificity for IEF.