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BC: Articoli scritti da M. Lazzaroni

Determinazione delle immunoglobuline e delle catene leggere libere nel siero e nel liquido cefalorachidiano di un paziente con patologia autoinfiammatoria
Serum and cerebrospinal fluid immunoglobulins and free light chains measurements in a patient with autoinflammatory disease
<p>Serum and cerebrospinal fluid immunoglobulins and free light chains measurements in a patient with autoinflammatory disease. We report a case of a patient with chronic meningitis, headache, deafness, leukoencephalopathy, and osteomyelitis who showed a selective interleukin-6 (IL-6) overproduction. An inflammatory pattern was observed in serum; the cerebrospinal fluid (CSF) examination revealed positive oligoclonal IgG bands and IgG, IgA, IgM intrathecal synthesis. CSF free light chains (FLC) indices were very high. Steroids gave modest benefits. IL-6 was persistently increased in CSF and serum; after treatment with Tocilizumab, an anti IL6-receptor monoclonal antibody, the serum inflammatory pattern normalized and FLC decreased. Central neurological symptoms improved to a lesser degree than systemic ones, probably due to Tocilizumab blood-brain barrier restriction. The biochemical CSF parameters showed partial improvement: the albumin ratio decreased, immunoglobulin intrathecal synthesis and oligoclonal bands were no more detectable, but FLC absolute values and indices remained elevated, confirming persisting CSF inflammation. This is the first report on Tocilizumab and steroid treatment effects on FLC concentrations. FLC measurement both in serum and CSF could be useful markers both for diagnosis and evaluation of the response to therapy in the inflammatory and immunological processes of SNC.</p>
Biochimica Clinica ; 40(1) e4-e7
Casi clinici - Case report
 
L’evoluzione dei criteri diagnostici per la sclerosi multipla non ha modificato la quota di pazienti con bande oligoclonali nel liquor
The evolution of diagnostic criteria for multiple sclerosis (MS) did not change the rate of patients displaying oligoclonal bands in the cerebrospinal fluid (CSF)
<p>The early diagnosis of MS, an inflammatory disease of the&nbsp;central nervous system, can be difficult. Although a specific laboratory test is lacking, the presence of CSF-restricted&nbsp;oligoclonal bands has been reported in the majority of patients (80-95%); as a consequence, this test has been&nbsp;included in the diagnostic criteria for many years. However, after each revision of the diagnostic criteria, the relevance&nbsp;of this test has progressively lost in importance, while magnetic resonance imaging has gained a central role. In the&nbsp;present study, two groups of MS patients diagnosed with McDonald (2001 and subsequent revisions) or with Poser&nbsp;(1983) criteria (176 and 82, respectively) were compared with regard to the frequency of the presence of oligoclonal&nbsp;bands in CSF. The same method for the oligoclonal pattern detection, based on isoelectric focusing followed by&nbsp;blotting and immunodetection of IgG, was used on both groups. Results showed that the rate of patients displaying&nbsp;CSF-restricted oligoclonal bands was 89.0% and 89.8% in the two groups, respectively (P=0.57). Our data suggest&nbsp;that the percentage of MS patients with CSF-restricted oligoclonal bands was unchanged and independent of the&nbsp;diagnostic criteria. Furthermore, the results suggest that the different MS diagnostic criteria considered (Poser vs.&nbsp;McDonald) identify patients with a similar immunological background.</p>
Biochimica Clinica ; 38(3) 213-217
Contributi scientifici - Scientific Papers