What is the clinical application of an immunofixation test?

Updated: Jul 29, 2019
  • Author: Anastasios Dimou, MD; Chief Editor: Eric B Staros, MD  more...
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The identification of a monoclonal immunoglobulin is helpful in the diagnosis of the following conditions [2] :

The identification of oligoclonal bands in CSF is helpful in the diagnosis of multiple sclerosis. [9]

In addition, immunofixation can be used to monitor therapy in plasma cell dyscrasias (ie, multiple myeloma and Waldenstrom macroglobulinemia). If the monoclonal protein level decreases or is undetectable after chemotherapy, it might indicate a response to treatment. On the contrary, a persistent monoclonal protein despite treatment is a sign of refractory disease. [10]

The presence of oligoclonal bands in CSF but not in the serum, given their intrathecal production, is helpful in the diagnosis of multiple sclerosis. Other inflammatory conditions of the CNS can present with oligoclonal bands in CSF resulting from intrathecal production of antibodies. [11] HIV-related encephalitis, neurosyphilis, Lyme meningoencephalitis, neurosarcoidosis, acute disseminated encephalomyelitis (ADEM), systemic lupus erythematosus (SLE), Sjögren syndrome, subacute sclerosing panencephalitis, CNS malignancy, neuromyelitis optica, and transverse myelitis can all reveal oligoclonal banding in CSF immunofixation, precluding the use of immunofixation for the detection of oligoclonal bands as a sole diagnostic technique in multiple sclerosis.

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