Cerebrospinal fluid IgG profiles and multiple sclerosis in Japan.

We analyzed the cerebrospinal fluid (CSF) IgG profiles of 46 Japanese patients with relapsing and remitting types of multiple sclerosis (MS). There were 12, 13 and 21 patients, with inactive, active and both clinical conditions, respectively. The values for IgG, IgG/Alb ratio, IgG index and IgG synthesis rate were significantly higher during active than during inactive stages, but the patients with high values for these IgG profiles during active stages tend to also have high values during inactive stages. None of 33 (0%) and 2 of 34 patients (5.9%) exhibited abnormal IgG levels, 3 (9.1%) and 8 (23.5%) an abnormal IgG/Alb ratio, 9 (27.3%) and 18 (52.9%) an abnormal IgG index, and 5 (15.2%) and 14 (41.2%) an abnormal IgG synthesis rate, during inactive and active stages, respectively. Some of HLA antigen frequencies were significantly different between the patients with and without abnormal CNS IgG profiles. Increased CSF IgG was of lesser diagnostic value for MS in Japan, and seemed to be a function of immunogenetics rather than clinical activity.