DIAGNOSTIC TEST PANEL 581
Multiple Sclerosis (MS)
Diagnostic test panel for NfL, GFAp, and antibodies against AQP4 and MOG. For suspicion of multiple sclerosis.
Indication
Suspicion of multiple sclerosis
Sample material
Serum
- Minim. volume: 1,5 mL (0,5 mL x 3 tubes)
CSF
- Minim. volume: 1,5 mL (0,5 mL x 3 tubes)
Transport
Within Sweden
- frozen
International
- frozen
Clinical background
Multiple Sclerosis (MS) is an inflammatory demyelinating disease affecting the central nervous system (CNS). The diagnosis of MS is based on medical history, clinical neurological examination, magnetic resonance imaging (MRI) of the nervous system, and characteristic cerebrospinal fluid (CSF) findings.
Neurofilament light protein (NfL) is a subunit of the neuronal cytoskeleton in both the central and peripheral nervous systems (CNS and PNS). In cases of axonal damage in the CNS, NfL leaks into the CSF, and elevated levels can be detected in serum/plasma with a high correlation.
Serum/plasma NfL levels can reflect the degree of neuronal degeneration in both CNS and PNS injuries. Since NfL levels in serum/plasma vary significantly among individuals in the general population, reference ranges are broad. Therefore, it is recommended to monitor patients individually, with a sample taken when the disease has shown no signs of active inflammation for at least the previous three months. This value can then serve as the individual's reference, and a difference of more than 20% between two samples is considered significant. Elevated NfL levels in CSF may indicate a worse prognosis for MS patients.
Glial Fibrillary Acidic Protein (GFAP) is present in astrocytes in the CNS. GFAP expression increases during astrocyte activation and is released into CSF following tissue damage. GFAP can cross the blood-brain barrier (BBB) into the bloodstream, and its levels in blood can be used to monitor CNS injury. Blood GFAP serves as a nonspecific marker reflecting the extent and severity of CNS damage. In the diagnosis of neuroinflammatory conditions, CSF GFAP levels can be valuable in distinguishing between multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD), which initially can be difficult to differentiate clinically.
Neuromyelitis Optica Spectrum Disorder (NMOSD) is an inflammatory, demyelinating disease of the central nervous system. The primary characteristics of NMOSD are recurrent episodes of optic neuritis or acute myelitis. Previously classified as a variant of multiple sclerosis (MS), NMOSD is now recognized as a distinct disease entity.
Most patients with NMOSD test positive for AQP4 antibodies, but some instead have MOG antibodies and are diagnosed with Myelin Oligodendrocyte Glycoprotein Antibody Disease (MOGAD). Although NMOSD and MOGAD share similar clinical features, their pathogenesis and disease progression differ from MS. A differential diagnosis from MS is crucial, as NMOSD and MOGAD require different treatment strategies.
For suspected MS or patients exhibiting these symptoms, serological testing including both MOG and AQP4 antibody testing using live cell-based assays (Live CBA) are recommended.
Tests included in panel
Need pricing information?
How to order
This test panel is available worldwide for hospitals, clinics, and physicians.
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Print and complete the request form
Download the request form. Clearly state the name and phone number of the referring hospital, clinic, or physician. -
Prepare your samples
Serum: At least 3 tubes x 0.5 mL serum (plain serum tubes without additives).
CSF: At least 3 tubes x 0.5 mL CSF (polypropylene tubes).
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Send samples and request form
Within Sweden
Send samples frozen to:
Envelopes and smaller boxes:
Wieslab AB, Box 50117, 20211 Malmö, Sweden
Larger boxes and frozen samples:
Wieslab AB, Lundavägen 151, 21224 Malmö, Sweden
International
Send samples frozen to:
Wieslab AB, Lundavägen 151, 21224 Malmö, Sweden
Last updated: 2025-08-18
