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Test Code MSP3 Multiple Sclerosis (MS) Cascade, 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:

1. Submit CSF from collection vial no. 4.(preferred); vial no. 1, 3, 2 are also acceptable (in this order).

2. Label specimen as spinal fluid.

 

Specimen Type: Serum

Supplies: Sarstedt Aliquot Tube 5 mL (T914)

Collection Container/Tube:

Preferred: Serum gel

Acceptable: Red top

Submission Container/Tube: Plastic vial

Specimen Volume: 1 mL

Collection Instructions:

1. Within 2 hours of collection, centrifuge and aliquot serum into a plastic vial.

2. Label specimen as serum.


Children's Mercy Hospital Note:

CMH COLLECTION: 2 mL in red gel vacutainer AND 1 mL CSF in sterile cup

Specimen Minimum Volume

Serum, Spinal fluid: 0.5 mL

Specimen Stability Information

Specimen Type Temperature Time
CSF Frozen (preferred) 14 days
  Refrigerated  72 hours
  Ambient  24 hours
Serum Frozen (preferred) 14 days
  Ambient  14 days
  Refrigerated  14 days

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 test 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.

 

For more information see Central Nervous System Demyelinating Disease Diagnostic Algorithm.

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

Useful For

Diagnosing multiple sclerosis, especially helpful in patients with equivocal clinical or radiological findings

Reject Due To

Gross hemolysis Reject
Gross lipemia OK
Gross icterus OK

Day(s) Performed

Monday through Friday

Report Available

3 to 5 days

Reporting Name

Multiple Sclerosis Cascade

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 Name

KCSFP: Nephelometry

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

Performing Laboratory

Mayo Clinic Laboratories in Rochester

CPT Code Information

83521

83916 x2 (if appropriate)

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