Detecting disruptions of the blood-brain barrier or intrathecal synthesis of immunoglobulins
Reflectance Spectrophotometry
Protein, Total, CSF
CSF
Container/Tube: Sterile vial
Specimen Volume: 1 mL
Collection Instructions: Centrifuge specimen to remove any cellular material.
If not ordering electronically, complete, print, and send a Renal Diagnostics Test Request (T830) with the specimen.
0.25 mL
All specimens will be evaluated at Mayo Clinic Laboratories for test suitability. |
Specimen Type | Temperature | Time | Special Container |
---|---|---|---|
CSF | Refrigerated (preferred) | 72 hours | |
Frozen | 180 days |
Detecting disruptions of the blood-brain barrier or intrathecal synthesis of immunoglobulins
Cerebrospinal fluid (CSF) proteins are those that remain in CSF following the ultrafiltration of plasma through the choroidal capillary wall. Some proteins that are unique to CSF are synthesized in the central nervous system. In general, diseases that interrupt the integrity of the capillary endothelial barrier lead to an increase in the total CSF protein.
CSF protein is generally increased in all types of meningitis, cerebral infarction, brain abscess, meningovascular syphilis, subarachnoid hemorrhage, some brain tumors, trauma to the brain, some cases of multiple sclerosis, encephalomyelitis, and degenerative neurologic diseases. A decreased CSF protein may occur in water intoxication, CSF leak (CSF rhinorrhea or otorrhea), and hyperthyroidism.
> or =12 months: 0-35 mg/dL
Reference values have not been established for patients that are <12 months of age.
Striking elevations of cerebrospinal fluid (CSF) total protein are noted in bacterial
In order to assess increased permeability or increased intrathecal
Increased cerebrospinal fluid (CSF) total protein is sensitive, but not specific, for detecting disruptions of the blood-brain barrier or intrathecal synthesis of immunoglobulins.
The presence of hemoglobin in CSF will cause an increase in measured total protein by this method. Internal validation studies have been conducted to estimate the contribution of hemolysis to the measured total protein concentration, and are appended to the result as a comment in these situations. Results should be interpreted with caution as hemolysis may be present due to traumatic lumbar puncture or due to a CNS hemorrhagic process.
Specimens should be collected prior to the intrathecal administration of contrast media. Significant positive bias can occur when CSF contains contrast media. Examples of contrast media include Iopamidol, Iohexol, and Metrizamide.
Blood in the CSF specimen invalidates the protein value.
1. Tietz Textbook of Clinical Chemistry. Fourth edition. Edited by CA Burtis, ER Ashwood, DE Bruns. Philadelphia, WB Saunders Company, 2006
2. Killingsworth LM: Clinical applications of protein determinations in biological fluids other than blood. Clin Chem 1982;28:1093-1103
3. Henry’s Clinical Diagnosis and Management by Laboratory Methods. Cerebrospinal, synovial, and serous body fluids. Edited by McPherson and Pincus. Philadelphia, WB Saunders Co, 2007, 431-435
Patient sample is deposited on the slide and is evenly distributed by the spreading layer. Protein in the sample forms a complex with cupric ion and results in the dissociation of the cupric ion from the copper-azo dye complex. The decrease of the copper-azo dye complex is measured by the reflectance spectrophotometry and is proportional to the concentration of proteins in the sample.(Package insert: Vitros Chemistry Products Instructions for Use-PROT Slides, Ortho-Clinical Diagnostics, Inc. Rochester, NY 14626)
Monday through Sunday
This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.
84157
Test Id | Test Order Name | Order LOINC Value |
---|---|---|
TPSF | Protein, Total, CSF | 2880-3 |
Result Id | Test Result Name |
Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
|
---|---|---|
TPSF | Protein, Total, CSF | 2880-3 |