Clinical significance of immunologic and immunogenetic evaluation in multiple sclerosis.

One hundred thirty-two patients were separated into clinically defined groups of definite, probable and possible multiple sclerosis (MS), the spinal cord variant of MS (SCV), and non MS neurologic disease. HLA antigens A3 and B7 occurred at increased frequencies in definite and probably MS patients when compared with neurologic controls and healthy adults. CSF elevations of either kappa/lambda ratio, IgG/total protein ratio, or IgG were seen in 65% of the definite, probable and SCV groups. Patients with HLA A3 and B7 antigens had a higher than predicted incidence of elevated kappa/lambda ratio, suggesting that there may be immunogenetic control mechanisms which influence this CSF parameter. Neither HLA antigens nor CSF protein abnormalities correlated with the age of onset, progression, or degree of disability of disease, thus limiting their prognostic usefulness.