Test Code TPCSF Protein CSF
Additional Codes
Cerner |
NextGen |
Protein CSF |
Protein CSF |
Useful For
Cerebrospinal fluid proteins are those that remain in CSF following ultrafiltration of plasma through the choroidal capillary wall. In general, diseases that interrupt the integrity of the capillary endothelial barrier lead to an increase in 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 leakage, and hyperthyroidism.
Methodology
Colorimetric (reflectance spectrophotometry) by modified biuret.
Patient Preparation
CSF should be collected prior to the intrathecal administration of contrast media such as lopamidol (Isovue-M), lohexol (Omnipaque), and Metrazimide (Amipaque).
Collection Instructions
- Specimens should be collected according to clinical policies and procedures.
- CSF specimens should be centrifuged and analyzed without delay.
- Hemolyzed specimens should not be used.
- CSF Tube Distribution:
Tube#1 |
Chemistry |
Tube#2 |
Microbiology |
Tube#3 |
Hematology |
Tube#4 |
Virology/Special/Hematology |
Specimen Requirements
Minimum Volume |
Due to the nature of CSF specimens, no volume is rejected, but if specimen volume is inadequate, not all testing may be completed. The provider and/or pathologist will be contacted to discuss test priority if specimen volume is inadequate. |
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Container |
CSF specific tubes without additive |
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Stability |
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Rejection Criteria |
Hemolyzed specimens |
Result Reporting and Reference Values
Reported in mg/dL.
Age |
Low |
High |
Critical |
<30 days |
10 |
120 |
N/A |
30 days – 3 months |
10 |
75 |
N/A |
3 months – 18 years |
10 |
40 |
N/A |
18 – 150 years |
12 |
60 |
N/A |
Reflex Testing
None
Limitations
- Ortho reports a bias with the following:
- Ampicillin at 10 mg/dL can have a bias of 21.0 mg/dL
- Ascorbic acid at 3 mg/dL can have a bias of 13.0 mg/dL
- Bilirubin at 5 mg/dL can have a bias of 13.7 mg/dL
- Dextran at 500 mg/dL can have a bias of 48 mg/dL
- Mannitol at 1000 µg/mL can have a bias of 12 mg/dL
- Salicylic acid can have a positive bias-consult IFU
- Vancomycin at 10 mg/dL can have a bias of 13.5 mg/dL
- The following interpretive data is visible to the practitioner:
- Significant positive bias noted with contrast media. The following drugs will create a positive bias: Ampicillin, ascorbic acid, Dextran, Mannitol, Salicylic acid, Vancomycin.