The analysis of mirror pattern bands synthesized in patients with neurological disorder during Oligoclonal immunoglobulin isoelectric focusing electrophoresis

Abstract Background The analysis of oligoclonal band (OCB) of cerebrospinal fluid is of vital importance for the clinical diagnosis and differential diagnosis of neurological disease. However, there still exists limited knowledge about the interpretation of the mirror pattern bands (one of OCB results) for the neurological disorders during the clinal courses. In this study, we thoroughly analyzed the 12 patients with mirror pattern bands combined with laboratory and clinical information in order to explore the clinical implications of mirror bands as much as possible. Methods Matched CSF and serum specimens were obtained from 5892 patients with various neurological disorders who were required to lumber puncture for OCB analysis over the past four years in the Neurological Special Examination Laboratory of XuanWu Hospital. A total of 12 patients with mirror pattern bands were screened out from the 5892 patients. Serum immunofixation electrophoresis (IFE) was then performed on the 12 patients respectively in order to tentatively explore the correlation with M protein. We also collected the clinical and laboratory information of the 12 patients in great detail. Results All three types of mirror patterns are closely connected with M protein from peripheral serum. However, not all patients with the mirror patterns present positive M protein. 7 out of 12 patients (58.3%) were finally diagnosed as blood system-related diseases. None of the 12 patients were diagnosed with Multiple Sclerosis (MS). Conclusions Great emphasis should be taken on the mirror pattern bands during the isoelectric focusing electrophoresis (IEF). The mirror pattern bands combined with the result of M protein will greatly contributes to the differential diagnosis of neurological disorder.