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Protein, Cerebrospinal Fluid


Definition


  • CSF protein concentration is one of the most sensitive indicators of pathology within the CNS.
  • Normal range: 15 " “45 mg/dL.

Use


  • To detect increased permeability of the blood " “brain barrier to plasma proteins
  • To detect increased intrathecal production of immunoglobulins

Interpretation


Increased In


  • Bacterial meningitis
  • Brain tumor
  • Brain abscess
  • Aseptic meningitis
  • Multiple sclerosis
  • Cerebral hemorrhage
  • Epilepsy
  • Acute alcoholism
  • Neurosyphilis

Decreased In


  • Repeated lumbar puncture or a chronic leak, in which CSF is lost at a higher than normal rate
  • Some children between the ages of 6 months and 2 years
  • Acute water intoxication
  • Minority of patients with idiopathic intracranial hypertension

Limitations


  • CSF protein levels do not fall in hypoproteinemia.
  • The normal reference ranges is somewhat technique dependent and vary from laboratory to laboratory.
  • Excessive amounts of CSF proteins are seen in Froin syndrome, clotted specimens, xanthochromia, or the presence of free blood.
  • In premature infants, values >130 mg/dL may occasionally be observed.
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