Background The objective was to evaluate the precision of kappa and lambda free light chains (KFLC and LFLC) in CSF for the diagnosis of multiple sclerosis (MS) and prognosis of clinically isolated syndrome (CIS). Methods CSF and serum samples from CIS, MS and other neurological non-MS disease were collected between 2015 and 2017. FLC concentrations were measured using immunoassay Freelite™. Results were correlated with the patients' diagnoses and ROC curve analysis was used to determine accuracy. In CIS patients, analysis of FLC were compared in CIS converters vs. non-converter during follow-up. Results In the MS group (n = 41), the optimal cut-off for KFLC determined was 7 mg/L, with a diagnostic sensitivity and specificity of 95% and 97%, respectively. The optimal cut-off for LFLC was 0.7 mg/L, with a diagnostic sensitivity and specificity of 71% and 81%, respectively. 36 CIS patients were included; mean follow-up time was 28 ± 9 months, and 22 (61.1%) patients converted to MS. The median concentration of CSF K and LFLCs at CIS diagnosis was slightly higher in CIS-converters compared to non-converters, but this did not reach statistical significance (KFLC: median 7 ± 5.3 mg/L vs. 5 ± 2.3 mg/L, p = 0.11; LFLC 0.7 ± 0.33 mg/L vs. 0.5 ± 0.23 mg/L p = 0.16). A strong correlation was observed between the concentration of K and L FLCs at diagnosis and the change in PBVC during follow-up (r = 0.72 and r = 0.65, respectively). Conclusion KFLCs have a high sensitivity and specificity for the diagnosis of MS. FLC concentrations at CIS diagnosis were not significantly higher in CIS-converters.
Introducción: la obesidad es una enfermedad crónica de características epidémicas determinada, entre otras variables, por la interacción de factores genéticos y medioambientales. En pacientes obesos se presenta la dislipemia con un fenotipo aterogénico.La cirugía bariátrica (CB) constituye una alternativa terapéutica eficaz para la disminución del riesgo cardiovascular en tanto mejora el perfil lipídico.Objetivos: comparar las diferencias en el perfil lipídico antes y después de someter a los pacientes del Hospital Italiano de Buenos Aires a dos técnicas distintas de cirugía bariátrica con un seguimiento al año de la intervención.Materiales y métodos: en el presente estudio se incluyeron todos los pacientes sometidos a CB en el año 2015 (n=138) en el Hospital Italiano de Buenos Aires.Resultados: la reducción de los niveles de colesterol total, triglicéridos y LDL así como el aumento de HDL al año de la intervención fueron estadísticamente significativos y no se hallaron diferencias al comparar los deltas de cada variable del perfil lipídico entre dos técnicas quirúrgicas diferentes.Conclusiones: la CB puede constituir un tratamiento efectivo en pacientes obesos con dislipidemia que no respondan a la terapia farmacológica dado que se observan cambios significativos en el perfil lipídico.
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