Leukocyte profiles in blood and CSF distinguish neurosarcoidosis from multiple sclerosis

J Neuroimmunol. 2020 Apr 15:341:577171. doi: 10.1016/j.jneuroim.2020.577171. Epub 2020 Jan 27.

Abstract

Distinguishing neurosarcoidosis (NS) from multiple sclerosis (MS) remains challenging and available parameters lack discriminatory power. Comprehensive flow cytometry data of blood and CSF leukocytes of patients with NS (n = 24), MS (n = 49) and idiopathic intracranial hypertension (IIH, n = 52) were analyzed by machine learning algorithms. NS featured a specific immune cell pattern with increased activated CD4+ T cells in CSF and increased plasma cells in blood. Combining blood and CSF parameters improved the differentiation. We thereby identify and independently validate a multi-dimensional model of blood and CSF supporting the difficult differential diagnosis between NS and MS.

Keywords: Flow cytometry; Immune cell profile; Multiple sclerosis; Neuroinflammation; Neurosarcoidosis.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't
  • Validation Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • CD4-Positive T-Lymphocytes / immunology
  • Cell Separation
  • Central Nervous System Diseases / blood
  • Central Nervous System Diseases / cerebrospinal fluid
  • Central Nervous System Diseases / diagnosis*
  • Central Nervous System Diseases / immunology
  • Diagnosis, Differential
  • Female
  • Flow Cytometry
  • Humans
  • Leukocyte Count
  • Leukocytes*
  • Lymphocyte Activation
  • Male
  • Middle Aged
  • Models, Immunological
  • Multiple Sclerosis / blood
  • Multiple Sclerosis / cerebrospinal fluid
  • Multiple Sclerosis / diagnosis*
  • Multiple Sclerosis / immunology
  • Retrospective Studies
  • Sarcoidosis / blood
  • Sarcoidosis / cerebrospinal fluid
  • Sarcoidosis / diagnosis*
  • Sarcoidosis / immunology
  • Young Adult

Supplementary concepts

  • Neurosarcoidosis