CSF Immunoglobulin G (IgG) Index: MedlinePlus Medical Test (2024)

What is a CSF IgG index?

CSF stands for cerebrospinal fluid. It is a clear, colorless fluid that flows in and around your brain and spinal cord. Your brain and spinal cord make up your central nervous system. Cerebrospinal fluid cushions your central nervous system from impact or injury. It also removes waste products from the brain and helps your central nervous system work properly.

IgG stands for immunoglobulin G. It is a type of antibody. Antibodies are proteins that your immune system makes to fight germs.

A CSF IgG index measures the levels of IgG in your cerebrospinal fluid. Normally you have a tiny amount of IgG in your cerebrospinal fluid. High levels of IgG may mean you have an infection or an inflammatory or autoimmune disease that involves your central nervous system. An autoimmune disorder causes your immune system to attack your own healthy cells by mistake, which can lead to serious health problems.

Other names: cerebrospinal fluid IgG level, cerebrospinal fluid IgG measurement, CSF IgG level, IgG (Immunoglobulin G) spinal fluid, IgG synthesis rate

What is it used for?

A CSF IgG index is used to check for diseases of the central nervous system. It is often used to help diagnose multiple sclerosis (MS). MS is a chronic (long-lasting) autoimmune disorder that attacks the outside covering of your nerves.

Why do I need a CSF IgG index?

You may need a CSF IgG index if you have symptoms of a central nervous system disorder, especially multiple sclerosis (MS). The symptoms of MS often vary. They may come and go or steadily get worse. They include:

Blurred or double vision
Tingling, numbness, or pain in the arms, legs, body, or face
Painful muscle spasms
Weak muscles, often in the hands and legs
Dizziness
Problems with balance and walking
Bladder control problems
Fatigue
Problems with thinking or memory

What happens during a CSF IgG index?

To get a sample of cerebrospinal fluid, a provider will do a procedure called a spinal tap, also known as a lumbar puncture. A spinal tap is usually done in a hospital. During the procedure:

You will lie on your side or sit on an exam table.
A provider will clean your back and inject an anesthetic into your skin, so you won't feel pain during the procedure. Your provider may put a numbing cream on your back before this injection.
When the area on your back is completely numb, your provider will insert a thin, hollow needle between two vertebrae in your lower spine. Vertebrae are the small backbones that make up your spine.
Your provider will withdraw a small amount of cerebrospinal fluid for testing. This will take about five minutes.
You'll need to stay very still while the fluid is being withdrawn.
Your provider may ask you to lie on your back for an hour or two after the procedure. This may prevent you from getting a headache afterward.

Will I need to do anything to prepare for the test?

You don't need any special preparations for a CSF IgG index, but you may be asked to empty your bladder (pee) and bowels (poop) before the test.

Are there any risks to the test?

There is very little risk to having a spinal tap. You may feel a little pinch or pressure when the needle is inserted. After the test, you may feel some pain or tenderness in your back at the site where the needle was inserted.

You may also have some bleeding at the site or get a headache. The headache may last for several hours or up to a week or more, but your provider may suggest treatment to help relieve the pain.

What do the results mean?

A CSF IgG index that's higher than normal may be a sign of an infection or an inflammatory or autoimmune condition that affects your central nervous system, such as:

Multiple sclerosis
Transverse myelitis (TM)
Syphilis that infects your nervous system (neurosyphilis)
Connective tissue disorders
Guillain-Barre syndrome
Encephalitis caused by herpes simplex

You may need more tests before your provider can diagnose your condition.

A CSF IgG index that's lower than normal may be a sign that your body is unable to make enough IgG antibodies, and you are likely to get sick with infections. Experts don't know what causes this problem. Normally, a test of IgG levels in blood is used to check whether you may lack IgG antibodies.

If you have questions about your results, talk with your provider.

Learn more about laboratory tests, reference ranges, and understanding results.

Is there anything else I need to know about a CSF IgG index?

The CSF IgG index is often used to help diagnose multiple sclerosis (MS), but there is no specific test for MS. If your provider thinks you have MS, you will probably have other tests to help diagnose or rule out the disease.

While there is no cure for MS, there are many treatments available that can relieve symptoms and help keep it from getting worse.

References

Allina Health [Internet]. Minneapolis: Allina Health; Cerebrospinal fluid IgG measurement, quantitative; [cited 2022 May 26]; [about 3 screens]. Available from: https://account.allinahealth.org/library/content/49/150438
Hrishi AP, Sethuraman M. Cerebrospinal Fluid (CSF) Analysis and Interpretation in Neurocritical Care for Acute Neurological Conditions. Indian J Crit Care Med [Internet]. 2019 Jun [cited 2022 May 24];23(Suppl 2):S115-S119. doi: 10.5005/jp-journals-10071-23187. PMID: 31485118; PMCID: PMC6707491. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6707491/
Johns Hopkins Medicine [Internet]. The Johns Hopkins University; c2022. Health: IgG Deficiencies; [cited 2022 May 26]; [about 3 screens]. Available from: https://www.hopkinsmedicine.org/health/conditions-and-diseases/igg-deficiencies
Johns Hopkins Medicine [Internet]. The Johns Hopkins University; c2022. Health: Lumbar Puncture; [cited 2022 May 26]; [about 3 screens]. Available from: https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/lumbar-puncture
LabCorp [Internet]. Burlington (NC): Laboratory Corporation of America® Holdings and Lexi-Comp Inc; c2022. Immunoglobulin G Index; [cited 2022 May 24]; [about 4 screens]. Available from: https://www.labcorp.com/tests/002238/immunoglobulin-g-index
Labpedia.net [Internet].c.2014-2022. Cerebrospinal Fluid Analysis: Part 2 – CSF Complete Examinaiton, Normal/Abnormal CSF; [cited 2022 May 24]; [about 19 screens]. Available from: https://labpedia.net/cerebrospinal-fluid-analysis-part-2-csf-complete-examination-normal-abnormal-csf/
Mayo Clinic: Mayo Medical Laboratories [Internet]. Mayo Foundation for Medical Education and Research; c1995–2022. Test ID: SFINC: Cerebrospinal Fluid (CSF) IgG Index, Spinal Fluid; [cited 2022 May 26]; [about 2 screens]. Available from: https://www.mayocliniclabs.com/test-catalog/overview/2762#Clinical-and-Interpretive
Merck Manual Consumer Version [Internet]. Kenilworth (NJ): Merck & Co. Inc.; c2022. Tests for Brain, Spinal Cord, and Nerve Disorders; [modified 2021 Jul; cited 2022 May 26]; [about 8 screens]. Available from: https://www.merckmanuals.com/home/brain,-spinal-cord,-and-nerve-disorders/diagnosis-of-brain,-spinal-cord,-and-nerve-disorders/tests-for-brain,-spinal-cord,-and-nerve-disorders
National Cancer Institute [Internet]. Bethesda (MD): U.S. Department of Health and Human Services; NCI Dictionary of Cancer Terms: multiple myeloma; [cited 2022 May 16]; [about 2 screens]. Available from: https://www.cancer.gov/publications/dictionaries/cancer-terms/def/multiple-myeloma
National Institute of Neurological Disorders and Stroke [Internet]. Bethesda (MD): U.S. Department of Health and Human Services; Multiple Sclerosis: Hope Through Research; [reviewed 2022 Apr 18; cited 2022 May 26 ]; [about 11 screens]. Available from: https://www.ninds.nih.gov/health-information/patient-caregiver-education/hope-through-research/multiple-sclerosis-hope-through-research#3215_4
National Multiple Sclerosis Society [Internet]. National Multiple Sclerosis Society; c2022. Diagnosing MS; [cited 2022 May 26]; [about 3 screens]. Available from: https://www.nationalmssociety.org/Symptoms-Diagnosis/Diagnosing-MS
National Multiple Sclerosis Society [Internet]. National Multiple Sclerosis Society; c2022. MS Symptoms; [cited2022 May 26]; [about 4 screens]. Available from: https://www.nationalmssociety.org/Symptoms-Diagnosis/MS-Symptoms
Simonsen CS, Flemmen HØ, Lauritzen T, Berg-Hansen P, Moen SM, Celius EG. The diagnostic value of IgG index versus oligoclonal bands in cerebrospinal fluid of patients with multiple sclerosis. Mult Scler J Exp Transl Clin [Internet]. 2020 Jan 22 [cited 2022 May 23];6(1):2055217319901291. doi: 10.1177/2055217319901291. PMID: 32030196; PMCID: PMC6977237. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6977237/
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FAQs

CSF Immunoglobulin G (IgG) Index: MedlinePlus Medical Test? ›

A CSF IgG index is used to check for diseases of the central nervous system. It is often used to help diagnose multiple sclerosis (MS). MS is a chronic (long-lasting) autoimmune disorder that attacks the outside covering of your nerves. Most people with MS have higher than normal levels of IgG.

Keep Reading ›

What is the normal range for IgG in CSF? ›

reference range:

CSF Albumin: 5-34 mg/dL; CSF IgG: 0-4.5 mg/dL; Serum Albumin (Adult): 3.5 - 4.9 g/dL; Serum IgG (Adult): 620-1520 mg/dL; IGG INDEX: 17-29 years: 0.32-0.60, 30-39 years: 0.34-0.59, 40-49 years: 0.36-0.56, 50-59 years: 0.33-0.57, 60-150 years: 0.34-0.58.

What level of IgA is concerning? ›

Low IgA (<0.8g/L)

Patients may have a slightly higher risk of gastrointestinal diseases (including coeliac disease), autoimmune disease, or a modest increase in the rate of superficial infections.

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Does low IgG cause fatigue? ›

Individuals with immunoglobulin G deficiency (IgGsd) often complain of fatigue.

How to interpret IgG test results? ›

No reactivity – A normal and non-sensitive IgG response. Mild reactivity – A slightly elevated IgG response, usually with few symptoms. Moderate reactivity – A somewhat elevated IgG response, usually with mild symptoms. High reactivity – A strong IgG response, indicating a possible sensitivity.

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What are normal IgE levels by age? ›

Reference Values:

1 − 5 years: 0 − 60 IU/mL. 6 − 9 years: 0 − 90 IU/mL. 10 − 15 years: 0 − 200 IU/mL. Adults: 0 − 100 IU/mL.

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What foods cause high IgG levels? ›

The most frequent food specific IgG antibodies detected among the patients were against cola nut in 80.3% of patients followed by yeast (brewer's) in 78.9%, wheat in 77.5%, red kidney bean in 71.8%, pea in 63.4%, corn in 62.0%, egg white in 62.0%, barley in 57.7%, pistachio in 56.3%, cow's milk in 56.3% and gliadin in ...

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What infections cause a high IgG? ›

What infections cause a high IgG? A high IgG level may indicate a previous or ongoing infection with various pathogens, including viruses, bacteria, fungi, or parasites.

What are the symptoms of IgG disease? ›

Other common symptoms include fatigue, weight loss, headaches, dysfunction of the cranial nerves, bulging of one or both eyes, bulges on the sides of the face or below the chin, inflammatory tissue in the thyroid, large vessel vasculitis (inflammation in the blood vessel wall), shortness of breath, blockage of urine ...

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What is the normal range for IgG CSF? ›

Cerebrospinal fluid (CSF) IgG synthesis rate indicates the rate of increase in the daily CSF production of IgG in milligrams per day. A result greater than 12 mg/24h is elevated. A CSF index greater than 0.85 is elevated and indicative of increased synthesis of IgG.

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How do you treat high IgG levels? ›

Since hypergammaglobulinemia is caused by other conditions, there aren't many direct treatment options available. But you can improve or cure this condition by treating other underlying infections, immune disorders, and diseases. One uncommon treatment for this condition is immunoglobulin replacement therapy.

What is considered high IgG levels? ›

In adults, the usual level of IgG is 600-1600 mg/dL. However, the clinical situation is more important than a particular number, as “sometimes we have patients with levels at 300 mg/dL, for example, but they are never sick, so there is no need to consider replacement,” Dr. Rogers said.

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Does high IgG mean lupus? ›

IgG antinuclear antibodies (ANAs) are elevated in patients with systemic lupus erythematosus (SLE) compared with patients with discoid lupus erythematosus (DLE). To provide an expanded immunologic view of circulating ANAs in lupus patients, we compared the expressions of IgG, IgM, and IgA ANAs in DLE and SLE patients.

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What does high CSF IgG mean? ›

Additional Information. IgG index, synthesis rate, and oligoclonal bands have shown sensitivity at the 80% to 90% level but are not uniformly specific. CSF IgG may be increased, generally with inflammatory disorders of the CNS (eg, idiopathic polyneuropathy, neurosyphilis).

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Does high protein in CSF mean MS? ›

High Protein Levels in Spinal Fluid: A Potential Indicator of Multiple Sclerosis. The CSF of people with MS usually contains: A specific group of proteins called oligoclonal bands. Elevated CSF protein levels.

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What are the antibodies in CSF for MS? ›

IgG oligoclonal bands (OCB) are detected in the cerebrospinal fluid (CSF) of more than 90% of multiple sclerosis (MS) patients and are considered the immunological hallmark that supports MS diagnosis.

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What is the normal range of CSF protein in CSF? ›

Table 1

	Normal range
WBC types	Lymphocytes
CSF Proteins	15–40 mg/dL
CSF lactate	1–3 mmol/ L
CSF glucose	50–80 mg/dL (two thirds of blood glucose

6 more rows

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What is a normal CSF cell count for meningitis? ›

Meningitis can occur in children with normal CSF microscopy. If there is a high clinical suspicion of meningitis, children who have a normal CSF should still be treated with IV antibiotics, pending cultures. CSF white cell count and protein level are higher at birth and fall fairly rapidly in the first 2 weeks of life.

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What is CSF IgG albumin ratio? ›

Test ID: CASF IgG/Albumin Ratio, Spinal Fluid

The CSF index is the CSF IgG to CSF albumin ratio compared to the serum IgG to serum albumin ratio. The CSF index is therefore an indicator of the relative amount of CSF IgG compared to serum, and any increase in the index is a reflection of IgG production in the CNS.

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What does it mean if your IgG is low? ›

People with IgG deficiency are more likely to get infections. Although researchers don't know what causes primary IgG deficiency, genetics may play a role. When the symptoms come on later in life, the health problems may be more difficult to manage, and you may have more infections.

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