Multiple sclerosis (MS): laboratory red flags against diagnosis
Written and reviewed by Dr Ibrahim Imam, Consultant Neurologist. Last reviewed .
Multiple sclerosis (MS): laboratory red flags against diagnosis. Negative oligoclonal bands, Protein ≥ 100mg/dL. Fully referenced neurology checklist.
Cerebrospinal fluid red flags
- Negative oligoclonal bands
- Protein ≥ 100mg/dL
- White cell counts >50/µL
- Neutrophilic predominant white cells
- Eosinophilic predominant white cells
- Glucose <2/3 of serum level
- Positive serum angiotensin converting enzyme (ACE)
Magnetic lesions red flags
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MRI involvement pattern red flags
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MRI spinal cord prominent features red flags
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MRI enhancement pattern red flags
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MRI atrophy red flags
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Other MRI red flags
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References
- Solomon AJ, Arrambide G, Brownlee WJ, et al. Differential diagnosis of suspected multiple sclerosis: an updated consensus approach. Lancet Neurol 2023; 22:750-768.
- Arun T, Pattison L, Palace J. Distinguishing neurosarcoidosis from multiple sclerosis based on CSF analysis: A retrospective cohort study. Neurology 2020 (Online ahead of print).
Related checklists
- Multiple sclerosis (MS): classification
- Multiple sclerosis (MS): revised McDonald diagnostic criteria
- Multiple sclerosis (MS): non-modifiable risk factors
- Multiple sclerosis (MS): modifiable risk factors
- Multiple sclerosis (MS): protective factors
- Multiple sclerosis (MS): typical neurological features
- Multiple sclerosis (MS): other neurological features
- Multiple sclerosis (MS): systemic features
- Multiple sclerosis (MS): paroxysmal attacks
- Multiple sclerosis (MS): seizures
- Multiple sclerosis (MS): differential diagnosis
- Multiple sclerosis (MS): clinical red flags against diagnosis
- Multiple sclerosis (MS): poor prognostic factors
- Multiple sclerosis (MS): smouldering associated worsening
