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To the Editor:
In their article, Davies et al. deal with the clinical significance of a single CSF band that they found with isoelectric focusing (IEF), and they show that this single band is fairly frequently associated with MS.1 Pathologists who analyze CSF, and we too, occasionally face this CSF abnormality, which is not comprised in the five CSF/serum IEF- detectable band patterns that have been proposed as standard by a consensus report.2 Davies et al. consider the single band to be monoclonal. However, the “one band, one plasma cell clone” equivalence is definitely true in electrophoresis, but only possibly true in IEF. Two points should be considered.
The first point concerns IgG microheterogeneity due to post-translational modifications. Immunoglobulins are glycoproteins. Each glycidic residue modifies the isoelectric point in a way that is detectable with IEF. A paraprotein, which resolves in a single band in electrophoresis, can originate up to eight bands in IEF.3 Equidistant bands of decreasing intensity characterize the IEF pattern.2
The second …
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