期刊
CLINICAL CHEMISTRY AND LABORATORY MEDICINE
卷 54, 期 2, 页码 285-292出版社
WALTER DE GRUYTER GMBH
DOI: 10.1515/cclm-2015-0253
关键词
albumin quotient; cerebrospinal fluid; control patients; reference interval; total protein
Background: Determination of cerebrospinal fluid (CSF) total protein (TP) as well as of CSF/serum albumin quotient (Qalb) is part of the routine CSF work-up. However, currently used upper reference limits (URL) are not well validated leading to over-reporting of blood-CSF barrier dysfunction in approximately 15% of patients without neurological disease. The objective of this study was to determine age-related URL for CSF TP and Qalb in a cohort of control patients. Methods: A total of 332 paired CSF and serum samples of patients without objective clinical and paraclinical -findings of a neurological disease were analyzed for CSF TP and Qalb. CSF TP was measured by spectro-photometry and albumin in CSF and serum by nephelometry. Results: CSF TP concentration and Qalb significantly correlated with age. In subjects at the age of 18-70 years, median CSF TP ranged from 320 to 460 mg/L and URL defined as the 95th percentile were 530-690 mg/L. Median Qalb ranged from 4.1 to 6.1 and URL from 8.7 up to 11.0. For URL of Qalb we calculated the following formula: age/25+8. Conclusions: Age-dependent URL for CSF TP and Qalb are presented here in a large cohort of control patients. They are higher than those currently recommended and this probably explains why isolated blood-CSF barrier dysfunction has been apparently over-reported. These new URL might be considered in a future revision of CSF guidelines.
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