Il laboratorio clinico dà origine ad una diagnosi occasionale di sclerosi multipla

In February 2024, a 17-year-old woman, underwent a magnetic resonance imaging (MRI) of the brain following a car accident. The images showed ill-defined T2-hyperintense lesions in periventricular and juxtacortical regions, typical of multiple sclerosis (MS). The patient was then seen at the MS Center of the University of Naples; clinical history and neurological examination were normal. The results of hematological and biochemistry analyses were all within reference ranges, as were the main cerebrospinal fluid (CSF) parameters. Serum/CSF isoelectrofocusing for oligoclonal bands (OB) detection, was negative, while kFLC index (ratio between CSF/ serum kappa free light chains and CSF/serum albumin) was 15.9, higher than the proposed cut-off level (6.1), suggesting intrathecal immunoglobulin synthesis and inflammation, which are typically present in MS. At the moment, the girl is on stringent neurological and MRI follow-up.