CSF TRANSFERRIN

CLINICAL UTILITY:

Cerebrospinal fluid (CSF) leakage most commonly presents as otorrhea or rhinorrhea. Recurrent meningitis is a well-recognized, serious complication that can be prevented by early diagnosis of ectopic CSF. Evaluation of electrophoresis and immunofixation of CSF for transferrin has shown two isoforms in the beta region, where in the serum and other body fluids only one is observed. The slower desialated isoform is diagnostic for CSF. Therefore the presence of CSF specific transferrin in a bodily fluid other than known CSF indicates that leakage has occurred. This provides a valuable tool in the initial diagnosis of CSF leaks. While radiographic studies may be necessary to localize the leak prior to surgery, initial diagnosis can be made before exposing the patient to multiple and costly procedures.

METHOD DESCRIPTION:

Electrophoresis followed by immunofixation with anti-transferrin antibodies.

REFERENCE RANGE:

Negative.

SPECIMEN REQUIREMENTS:

0.5 ml CSF or other body fluid such as nasal fluid (0.2 ml min) and 0.5 ml serum (0.2 ml min- drawn within 48 hours of fluid collection) for comparison.