Reference values for CSF-IgM, CSF-IgM/S-IgM ratio and IgM index, and its application to patients with multiple sclerosis and aseptic meningoencephalitis

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Abstract
IgM concentrations were determined in CSF and serum (S) by enzyme-linked immunosorbent assay (ELISA). In 52 reference subjects, the upper reference limit was 0.46 mg/l for CSF-IgM, 0.32 .times. 10-3 for CSF-IgM/S-IgM ratio and 0.061 for IgM index equal to CSF-IgM .times. S-albumin/S-IgM .times. CSF-albumin ratio. No correlation to age over 15-85 yr was found for any of these variables. Among 22 patients with aseptic meningoencephalitis (AM) elevated values of CSF-IgM were found in 68%, CSF-IgM/S-IgM ratio in 73%, and IgM index in 73%. The corresponding values among 35 patients with multiple sclerosis (MS) were 66%, 60% and 63%. The differences in diagnostic sensitivities for the 3 IgM variables were not significant. Eleven of 16 AM patients and 2 of 22 with MS had elevated IgM index in the presence of normal IgG and IgA indices. Determination of IgM index should be performed in suspected inflammatory nervous system disorders.