What it is:
The CSF IgG Index is a specialized test that measures the amount of immunoglobulin G (IgG) in the cerebrospinal fluid (CSF) relative to the amount in the blood. This index helps determine whether IgG is being produced within the central nervous system (CNS)—a key sign of inflammation or immune system activity in the brain or spinal cord.
Why it matters:
An elevated CSF IgG Index suggests that the body is producing IgG inside the CNS, which is often associated with neurological conditions like multiple sclerosis (MS), central nervous system infections, or chronic inflammatory diseases. A normal index typically rules out significant intrathecal (within the CNS) IgG production.
How it's calculated:
The index is calculated using the formula:
(CSF IgG / Serum IgG) ÷ (CSF Albumin / Serum Albumin)
This adjusts for how much IgG might passively leak into the CSF from the bloodstream and helps isolate what’s being actively produced in the CNS.
When it’s used:
Doctors may order this test if you have symptoms like:
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Numbness, tingling, or weakness
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Vision changes
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Balance or coordination problems
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Signs of CNS infection or inflammation
Interpretation:
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High CSF IgG Index (>0.7–0.85, depending on lab): Suggests intrathecal IgG production; often seen in MS or chronic CNS infections
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Normal or low index: No significant CNS IgG production; can help rule out certain diseases
Takeaway:
The CSF IgG Index is a valuable marker for detecting immune activity within the brain or spinal cord, often helping diagnose or monitor diseases like multiple sclerosis. Results should always be interpreted alongside other tests (e.g., oligoclonal bands, MRI) and clinical findings by a healthcare provider.
What does it mean if your CSF IgG Index result is too high?
An elevated CSF IgG Index typically indicates that the immune system is producing IgG antibodies within the central nervous system (CNS)—a phenomenon known as intrathecal IgG synthesis. This finding is not normal and usually suggests inflammation or immune activation inside the brain or spinal cord.
What an Elevated CSF IgG Index May Indicate:
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Multiple Sclerosis (MS)
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One of the most common causes of an elevated CSF IgG index.
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Seen alongside oligoclonal bands and clinical symptoms such as optic neuritis, numbness, or motor weakness.
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Other Demyelinating Disorders
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Neuromyelitis optica (NMO), transverse myelitis, or other autoimmune neurological diseases.
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Chronic Central Nervous System Infections
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Conditions like neurosyphilis, HIV-associated neurocognitive disorders, Lyme disease, or tuberculous meningitis can cause elevated intrathecal IgG.
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Autoimmune or Inflammatory Conditions
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Such as lupus cerebritis, sarcoidosis, or other systemic diseases with CNS involvement.
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Important Notes:
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A CSF IgG Index ≥ 0.7–0.85 (depending on the lab's reference range) is considered elevated.
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It should always be interpreted alongside other tests, especially:
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Oligoclonal banding (OCBs)
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MRI of the brain and spine
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Clinical symptoms and neurological exam findings
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Takeaway:
An elevated index suggests abnormal immune activity in the CNS and may support the diagnosis of multiple sclerosis or another inflammatory or infectious neurological condition. Further testing and clinical correlation are essential to determine the exact cause.
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