Table 10 Overview of routine CSF parameters and approximate frequency of pathological results in PML
From: S1 guidelines “lumbar puncture and cerebrospinal fluid analysis” (abridged and translated version)
Parameter | 1st diagnostic lumbar puncture for PML | Follow-up during therapy (IRIS) a | Comment |
|---|---|---|---|
Cell number | ≤ 4/μL: 85% ≥ 5 - ≤ 50/μL: 10% > 50/μL: 5% | May increase during IRIS | Also dependent on the underlying disease and treatment. |
Cell differentiation | Normal or slightly activted. Lympho-monocytic | Also dependent on the underlying disease and treatment. | |
Total protein/ Albumin quotient | Normal: 50% Slightly elevated: 30% Severely elevated: 20% | ||
Quantitative IgG-, IgA-, IgM-synthesis | IgG > 0%: 25% IgA > 0%: 0% IgM > 0%: 0% | Is highly dependent on the underlying diseaseb | |
OCBs | 42% b | Highly dependent on the underlying diseaseb | |
JCPyV-PCR | Positive: 70-80% | May increase during IRIS before it normalizes | At first manifestation of PML: Sensitivity: 60-90% Specificity: 100% |