Lebrun C, Forzy G, Collongues N, Cohen M, de Seze J, Hautecoeur P
Service de neurologie, hôpital Pasteur, CHU de Nice, 30, voie Romaine, 06002 Nice, France.
Centre catholique de Lomme, université catholique de Lille, 56, rue du Port, 59046 Lille, France.
Rev Neurol (Paris). 2015 Apr;171(4):390-3. doi: 10.1016/j.neurol.2014.11.007. Epub 2015 Jan 19.
Although radiologically isolated syndrome (RIS) is a newly defined entity, incidental findings of T2 hypersignals on brain MRI can lead to misdiagnosis or useless investigations. The detection of oligoclonal bands (OCBs) in cerebrospinal fluid (CSF) is a major indicator that helps in diagnosis of subclinical inflammatory disease of the central nervous system, but lumbar puncture still remains an invasive option.
We have prospectively included patients with RIS, have compared the results of CSF and tear OCB detection by isoelectric focusing (IEF) and assessed concordance between OCB detection in tears and in CSF. Tears were collected using a Schirmer strip.
In 45 recruited RIS patients, OCBs were detected in CSF for 55% (25/45) and in tears for 50% (21/42) of samples.
We suggest that tear OCB detection may replace CSF OCB detection as a diagnostic tool in patients with RIS and be useful in follow-up.
尽管放射学孤立综合征（RIS）是一个新定义的实体，但脑磁共振成像（MRI）上T2高信号的偶然发现可能导致误诊或进行不必要的检查。脑脊液（CSF）中寡克隆带（OCB）的检测是有助于诊断中枢神经系统亚临床炎症性疾病的主要指标，但腰椎穿刺仍然是一种侵入性检查方法。
我们前瞻性纳入了RIS患者，通过等电聚焦（IEF）比较了脑脊液和泪液中OCB检测结果，并评估了泪液和脑脊液中OCB检测结果的一致性。使用泪液试纸收集泪液。
在45例纳入研究的RIS患者中，55%（25/45）的脑脊液样本和50%（21/42）的泪液样本检测到OCB。
我们建议，泪液OCB检测可替代脑脊液OCB检测，作为RIS患者的诊断工具，并有助于随访。
