Abstract Details

Title Matched or Unique Cerebrospinal Fluid Oligoclonal Bands: Clinical Characteristics and Diagnostic Utility

Topic Autoimmune Neurology

Presentation(s) S3 - Autoimmune Neurology 1: Mechanisms of Disease, Clinical Practice (2:36 PM-2:48 PM)

Poster/Presentation
Number 009

Background One means by which a diagnosis of autoimmune central nervous system disease is supported is via identification of unique oligoclonal bands in the cerebrospinal fluid. Previously considered an incidental finding, some patients have matched IgG bands present in both the CSF and serum. The clinical significance of matched oligoclonal bands in the context of possible neuroimmunologic or systemic disease has not been thoroughly investigated.

Objective Describe the clinical characteristics of patients with matched oligoclonal bands in paired cerebrospinal fluid (CSF) and serum samples.

Design/Methods Retrospective chart review of patients seen at University of Utah Health who had oligoclonal band analysis performed at ARUP Laboratories (Salt Lake City, UT) between January 1, 2015 and September 24, 2020. Only patients with matched or matched plus unique oligoclonal band results were analyzed. Clinical charts were reviewed by a neuroimmunologist.

Results We identified 502 patients with matched oligoclonal bands and 117 patients with matched plus unique oligoclonal bands. Those with matched oligoclonal bands only were more likely to be older (p<0.001) and to have systemic autoimmune disease (p 0.004). The most frequent coexisting systemic autoimmune diseases included hypothyroidism, systemic lupus erythematosus, and sarcoidosis. Patients with matched plus unique oligoclonal bands were more likely to have an abnormal MRI spine (p<0.001) and CSF pleocytosis (p<0.001). Patients with matched plus unique oligoclonal bands were more likely to have an inflammatory neurologic disease. Finally, in an adjusted logistic regression fit to death, there was a significant decrease in odds of death for those with matched plus unique oligoclonal bands compared to those with only matched bands (OR 0.52 [95% CI 0.29 - 0.94]).

Conclusions The presence of matched CSF and serum bands identifies a distinct population of patients as compared to patients with matched plus unique oligoclonal bands, and thus can assist clinicians in diagnostic evaluation, especially that of an autoimmune disorder.

Authors/Disclosures
Stefanie J. Rodenbeck, MD (Indiana University) PRESENTER	Dr. Rodenbeck has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion Pharmaceuticals. Dr. Rodenbeck has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for TG Therapeutics. Dr. Rodenbeck has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Amgen.
Justin Abbatemarco, MD (Cleveland Clinic Foundation)	Dr. Abbatemarco has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for EMD Serono. Dr. Abbatemarco has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Horizon. Dr. Abbatemarco has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Genentech . Dr. Abbatemarco has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for TG Therapeutics, Inc.. The institution of Dr. Abbatemarco has received research support from Horizon.
Jason T. Poon, MD (EvergreenHealth Neurology)	Dr. Poon has nothing to disclose.
Suzanne Liu, MD (University of Utah)	The institution of an immediate family member of Dr. Liu has received research support from NIH.
M. M. Paz Soldan, MD, PhD (University of Utah)	Dr. Paz Soldan has received personal compensation in the range of $500-$4,999 for serving as a Consultant for TG Therapeutics. The institution of Dr. Paz Soldan has received research support from National Institutes of Health. The institution of Dr. Paz Soldan has received research support from National Multiple Sclerosis Society. The institution of Dr. Paz Soldan has received research support from Western Institute for Biomedical Research. The institution of Dr. Paz Soldan has received research support from Biogen. The institution of Dr. Paz Soldan has received research support from Novartis. The institution of Dr. Paz Soldan has received research support from Clene Nanomedicine.
John E. Greenlee, MD, FAAN (University of Utah)	Dr. Greenlee has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Medlink. Dr. Greenlee has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Zeigler Cohen Roche. Dr. Greenlee has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Sommers Schwartz PC. Dr. Greenlee has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for St Francis Hospital. Dr. Greenlee has received publishing royalties from a publication relating to health care. Dr. Greenlee has received publishing royalties from a publication relating to health care.
John W. Rose, MD, FAAN (Imaging and Neurosciences Center)	The institution of Dr. Rose has received research support from National Multiple Sclerosis Society. The institution of Dr. Rose has received research support from Guthy Jackson Charitable Foundation. The institution of Dr. Rose has received research support from NIH . The institution of Dr. Rose has received research support from VA. The institution of Dr. Rose has received research support from Biogen. The institution of Dr. Rose has received research support from Friends of MS. Dr. Rose has received intellectual property interests from a discovery or technology relating to health care.
Lisa K. Peterson, PhD (ARUP Laboratories)	The institution of Dr. Peterson has received research support from Kronus.
Lisa Johnson (University of Utah / ARUP)	No disclosure on file
Stacey Clardy, MD, PhD, FAAN (University of Utah)	Dr. Clardy has received personal compensation for serving as an employee of Veterans Health Administration (VHA). Dr. Clardy has received personal compensation for serving as an employee of University of Utah Health. Dr. Clardy has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for AstraZeneca/Alexion. Dr. Clardy has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Amgen/Horizon. Dr. Clardy has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Arialys. Dr. Clardy has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Kyverna. Dr. Clardy has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Neurology/AAN Publications. The institution of Dr. Clardy has received research support from NIH/NINDS. The institution of Dr. Clardy has received research support from SRNA. The institution of Dr. Clardy has received research support from Alexion/AstraZeneca. Dr. Clardy has received personal compensation in the range of $500-$4,999 for serving as a AAN Summer Meeting CoDirector Travel and Lodging with AAN. Dr. Clardy has received personal compensation in the range of $500-$4,999 for serving as a Grand Rounds Travel/Lodging/Honoraria with U of Iowa, Miami, Stanford, Barrow, Beaumont Health, CCF, Emory, Penn State, Mayo Clinic, Walter Reed.