Clinically Isolated Syndrome
Free light chain analysis in CSF has been shown to have prognostic value in CIS to MS conversion
Clinically isolated syndrome (CIS) is an initial episode of neurological symptoms lasting at least 24 hours that is caused by inflammation or demyelination in the central nervous system (CNS).
CIS patients do not meet the diagnostic criteria for multiple sclerosis (MS), but studies have shown that around 60% of patients will develop MS during 20 years of follow-up.1 Therefore there is significant clinical interest in identifying markers that evaluate CIS prognosis, and identify those patients at highest risk of MS conversion.
Recent research has shown the prognostic value of κ free light chains (FLC) in predicting CIS to MS conversion.2 In CIS patients, the κ FLC index is highly elevated compared to controls (Figure 1).3 Patients with a κ FLC index above a defined cut-off (10.62, defined by ROC analysis) had a higher risk of conversion to MS than those below this value (Figure 2).2
κ FLC index equation - κ FLC index = κ FLCCSF/ κ FLCserum / albuminCSF/Albuminserum