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HelpTest Code KCSFP Immunoglobulin Kappa Free Light Chain, Spinal Fluid
Ordering Guidance
For evaluation of multiple sclerosis, the following are available:
-SFIG / Cerebrospinal Fluid IgG Index Profile, Serum and Spinal Fluid
-OLIG / Oligoclonal Banding, Serum and Spinal Fluid
Specimen Required
Only orderable as part of a profile. For more information see MSP3 / Multiple Sclerosis (MS) Profile, Serum and Spinal Fluid.
Specimen Type: Spinal fluid
Container/Tube: Sterile vial
Specimen Volume: 1 mL
Collection Instructions: Label specimen as spinal fluid.
Useful For
Diagnosis of multiple sclerosis and other demyelinating conditions
Method Name
Only orderable as part of a profile. For more information see MSP3 / Multiple Sclerosis (MS) Profile, Serum and Spinal Fluid.
Nephelometry
Reporting Name
Kappa Free Light Chain, CSFSpecimen Type
CSFSpecimen Minimum Volume
0.5 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| CSF | Frozen (preferred) | 28 days | |
| Refrigerated | 72 hours | ||
| Ambient | 24 hours |
Reference Values
Only orderable as part of a profile. For more information see MSP3 / Multiple Sclerosis (MS) Profile, Serum and Spinal Fluid.
Medical decision point: 0.1000 mg/dL
Interpretation
When result is greater than or equal to 0.1000 mg/dL, the kappa free light chain concentration measured in cerebrospinal fluid (CSF) is at or greater than the threshold associated with demyelinating disease. This is a positive result. These findings, however, are not specific for multiple sclerosis (MS) because CSF-specific immunoglobulin synthesis may also be detected in patients with other neurologic diseases (infectious, inflammatory, cerebrovascular, autoimmune, and paraneoplastic). Clinical correlation is recommended. Automatic reflexing to oligoclonal bands will occur.
When result is less than 0.0600 mg/dL, the kappa free light chain concentration measured in CSF is lower than the threshold associated with demyelinating disease. This is a negative result. Testing for oligoclonal banding is not performed. Clinical correlation is recommended.
When result is from 0.0600 to 0.0999 mg/dL, the kappa free light chain concentration measured in CSF is slightly elevated but not above the medical decision point of 0.1000 mg/dL associated with demyelinating disease. This is a borderline result. Reflexing to oligoclonal bands will be automatically performed and clinical correlation is recommended.
Clinical Reference
1. Thompson AJ, Banwell BL, Barkhof F, et al: Diagnosis of multiple sclerosis: 2017 revisions of the McDonald criteria. Lancet Neurol. 2018 Feb;17(2):162-173
2. Gurtner KM, Shosha E, Bryant SC, et al: CSF free light chain identification of demyelinating disease: comparison with oligoclonal banding and other CSF indexes. Clin Chem Lab Med. 2018 Jun;56(7):1071-1080
3. Saadeh R, Pittock S, Bryant S, et al: CSF kappa Free Light Chains as a Potential Quantitative Alternative to Oligoclonal Bands in Multiple Sclerosis. American Academy of Neurology Annual Meeting. Philadelphia, PA. 2019
4. Fortini AS, Sanders EL, Weinshenker BG, Katzmann JA: Cerebrospinal fluid oligoclonal bands in the diagnosis of multiple sclerosis. Isoelectric focusing with IgG immunoblotting compared with high-resolution agarose gel electrophoresis and cerebrospinal fluid IgG index. Am J Clin Pathol. 2003 Nov;120(5):672-675
5. Awad A, Hemmer B, Hartung HP, Kieseier B, Bennett JL, Stuve O: Analyses of cerebrospinal fluid in the diagnosis and monitoring of multiple sclerosis. J Neuroimmunol. 2010 Feb;219(1-2):1-7
6. Hassan-Smith G, Durant L, Tsentemeidou A, et al: High sensitivity and specificity of elevated cerebrospinal fluid kappa free light chains in suspected multiple sclerosis. J Neuroimmunol. 2014 Nov;276(1-2):175-179
7. Presslauer S, Milosavljevic D, Brucke T, Bayer P, Huebl W: Elevated levels of kappa free light chains in CSF support the diagnosis of multiple sclerosis. J Neurol. 2008 Oct;255(10):1508-1514
8. Presslauer S, Milosavljevic D, Huebl W, et al: Validation of kappa free light chains as a diagnostic biomarker in multiple sclerosis and clinically isolated syndrome: A multicenter study. Mult Scler. 2016 Apr;22(4):502-510
9. Presslauer S, Milosavljevic D, Huebl W, Parigger S, Schneider-Koch G, Bruecke T: Kappa free light chains: Diagnostic and prognostic relevance in MS and CIS. PLoS ONE. 2014 Feb;9(2):e89945
10. Makshakov G, Nazarov V, Kochetova O, Surkova E, Lapin S, Evdoshenko E: Diagnostic and prognostic value of the cerebrospinal fluid concentration of immunoglobulin free light chains in clinically isolated syndrome with conversion to multiple sclerosis. PLoS One. 2015 Nov;10(11):e0143375
Day(s) Performed
Monday through Friday
Report Available
1 to 3 daysPerforming 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
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| KCSFP | Kappa Free Light Chain, CSF | 48774-4 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| KCSFP | Kappa Free Light Chain, CSF | 48774-4 |