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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.

Container

CSF specific tubes without additive

Stability

Storage

Temperature

Stability

Room Temperature

18–28 °C

≤ 4 hours

Refrigerated

2–8 °C

≤ 3 days

Frozen

≤-18 °C

≤ 6 months

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.