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Test Code MSP3 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.


Secondary ID

607837

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.

Method Name

KCSFP: Nephelometry

OLIGC, OLIGS: Isoelectric Focusing (IEF) with IgG Immunoblot Detection

Reporting Name

Multiple Sclerosis Profile

Specimen Type

CSF
Serum

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

Method Description

Kappa Free Light Chain:

Kappa free light chain is measured by nephelometric method in which the light scattered onto the antigen-antibody complexes is measured. The intensity of the measured scattered light is proportional to the amount of antigen-antibody complexes in the sample under certain conditions.

 

Antigen-antibody complexes are formed when a sample containing antigen and the corresponding antiserum are put into a cuvette. A light beam is generated with a light emitting diode , which is transmitted through the cuvette. The light is scattered onto the immuno-complexes that are present. An antigen-antibody complex is formed in the final measurement.

 

The result is calculated by subtracting the value of the final measurement from the initial measurement. The distribution of intensity of the scattered light depends on the ratio of the particle size of the antigen-antibody complexes to the radiated wavelength.(Instruction manual: Siemens Nephelometer II. Siemens, Inc; Version 2.3, 2008; Addendum to the Instruction Manual 2.3, 08/2017)

 

Oligoclonal Banding:

The oligoclonal banding  assay requires paired cerebrospinal fluid (CSF) and serum samples. Unconcentrated CSF and diluted serum are electrophoresed by isoelectric focusing. The separated IgG bands are visualized by an IgG immunoblot, and oligoclonal bands that are present in the CSF and not in the serum are reported. The assay uses reagents from Helena Laboratories.( Saadeh RS, Ramos PA, Algeciras-Schimnich A, Flanagan EP, Pittock SJ, Willrich MA. An Update on Laboratory-Based Diagnostic Biomarkers for Multiple Sclerosis and Beyond. Clin Chem. 2022;68(9):1134-1150. doi:10.1093/clinchem/hvac061)

Day(s) Performed

Monday through Friday

Report Available

3 to 5 days

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Test Classification

This test has been modified from the manufacturer's instructions. Its performance characteristics were determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the US Food and Drug Administration.

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.