Intrathecal production of oligoclonal IgM and IgG in CNS sarcoidosis.

A longitudinal study of multiple paired CSF and serum specimens from a patient with CNS sarcoidosis revealed high CSF IgM and IgG indices as well as oligoclonal IgM and IgG bands in CSF reflecting intrathecal IgM and IgG production. The antibody specificity of intrathecally-produced IgM and IgG remained undefined despite analysis for antibodies against mycobacterium tuberculosis and Kveim suspension. Steroid treatment induced rapid and complete clinical remission, and also decrease of CSF IgM and IgG antibodies, while oligoclonal IgM and IgG persisted in CSF. Repeated determinations of these CSF variables together with cell count and CSF/serum albumin ratio as a variable of blood-brain barrier function, might be useful in assessing effect of therapy in CNS sarcoidosis.