Clinical and Etiopathological Evaluation of the Patients with OCB IgG Pattern-IV and V Positivity (P5.220)

OBJECTIVE: To determine the etiopathological profile and cerebrospinal fluid (CSF) characteristics of the oligoclonal IgG band (OCB) pattern-IV and V positive patients. BACKGROUND: The relations between OCB pattern-II with multiple sclerosis (MS) and pattern-V with monoclonal diseases such as multiple myeloma (MM) were well-known. However, the data regarding OCB pattern-IV and V associated diseases was limited. DESIGN/METHODS: Patients determined with a definitive diagnosis only after fullfillment of fundamental required work-up, and also being treatment naive at the time of the lumber pucture were enrolled to the study retrospectively. Serum and CSF samples of the pattern-IV (n=52) and V (n=15) positive patients were collected at the time of an acute (<1 month) and/or ongoing-progressive disease period between 2005-2013. OCB analyses were performed via isoelectric focusing (IEF). The routine serum and CSF characteristics, detailed demographic, clinic and radiologic data were obtained through a review of the medical records. RESULTS: Diagnostic spectrum of the 52 OCB-patern-IV positive patients (mean age 46, f/m=2/3) were classified as follows: 35[percnt] CNS inflammatory demyelinating diseases [CD-MS(14), CIS(4)], 19[percnt] peripheral inflammatory demyelinating diseases [GBS(6), CIDP(4)], 31[percnt] inflammatory non-demyelinating diseases [Neurobehcet’s syndrome(4), Tuberculosis(3), Sarkoidosis(2), Sjogren(2), vasculitis(2), Tholosa-Hunt-Syndrome(1), Dermatomyositis(1), Infectious mononucleosis(1)], 15[percnt] non-inflammatory non-demyelinating diseases [Prion(1), Motor neuron disease(1), Pseudotumor cerebri(2), Cerebrovascular disease(2), Malignency(2)]. Otherwise, 15 pattern-V positive patients (mean age 48, f/m=3/2) had shown diagnosis profile as follows: 13[percnt] CNS inflammatory demyelinating diseases [CD-MS(2)], 33[percnt] peripheral inflammatory demyelinating diseases [GBS(3), CIDP(2)], 40[percnt] inflammatory non-demyelinating diseases [Primary CNS angiitis(2), Monoclonal gammapathy(1), Neurobehcet’s syndrome(1), SLE(1), RA(1)] and 13[percnt] non-inflammatory non-demyelinating diseases [hereditary ataxia(1), malignancy(1)]. CONCLUSIONS: In our study group, MS had consisted the major part of OCB pattern-IV positive patients. Although, pattern-V was not found frequently as expected in monoclonal gammapathies, peripheral inflammatory polyneuropathies and vasculitis were involved in the first line. Disclosure: reports receiving honoraria from Merck-Serono and Teva.; S, Dr. Akkas-Yazici has nothing to disclose. Dr. Uygunoglu has nothing to disclose. Dr. Saruhan-Direskeneli has nothing to disclose. Dr. P. Yentur has nothing to disclose. Dr. Saip has nothing to disclose.