Pierre R Bourque1, Ari Breiner2, David Moher3, John Brooks4, Harald Hegen5, Florian Deisenhammer5, Christopher R McCudden6. 1. Division of Neurology, Department of Medicine, The Ottawa Hospital and University of Ottawa, Ottawa, Ontario, Canada; Ottawa Hospital Research Institute, Ottawa, Ontario, Canada. Electronic address: pbourque@toh.ca. 2. Division of Neurology, Department of Medicine, The Ottawa Hospital and University of Ottawa, Ottawa, Ontario, Canada; Ottawa Hospital Research Institute, Ottawa, Ontario, Canada. 3. Ottawa Hospital Research Institute, Ottawa, Ontario, Canada; Ottawa Methods Centre, Ottawa Hospital Research Institute, Ottawa, Canada. 4. Division of Neurology, Department of Medicine, The Ottawa Hospital and University of Ottawa, Ottawa, Ontario, Canada. 5. Department of Neurology, Neuroimmunology Laboratory, Medical University of Innsbruck, Innsbruck, Austria. 6. Department of Pathology & Laboratory Medicine, The Ottawa Hospital and University of Ottawa, Ontario, Canada.
Abstract
BACKGROUND: The cerebrospinal fluid total protein level (CSF-TP) is commonly used as a potential marker of infectious or immune disease of the CNS and PNS. Recent laboratory reference studies indicate that the antiquated single upper reference limit of 0.45 g/L commonly used by hospital laboratories and widely quoted in medical literature is a significant underestimation. METHODS: We distributed worldwide a web-based survey comprised of three questions: 1. What is the CSF-TP upper limit used at your institution? 2. What is the source of this upper limit? 3. Do you adjust your upper limit according to age? RESULTS: A total of 473 unique responses were obtained from North America (37.5%), South America (5.5%), Europe (29.4%), Africa (4%), Asia (21.6%) and Oceania (1.7%). A strong preponderance (86.8%) of institutions reported an upper limit of 0.45 g/L or less. Only 4% reported making age-partitioned adjustments. CONCLUSIONS: Worldwide, a strong majority of hospital laboratories presently use an underestimation of CSF-TP upper reference value, particularly for older adults. Recent well powered laboratory reference studies support higher values with age adjustment.
BACKGROUND: The cerebrospinal fluid total protein level (CSF-TP) is commonly used as a potential marker of infectious or immune disease of the CNS and PNS. Recent laboratory reference studies indicate that the antiquated single upper reference limit of 0.45 g/L commonly used by hospital laboratories and widely quoted in medical literature is a significant underestimation. METHODS: We distributed worldwide a web-based survey comprised of three questions: 1. What is the CSF-TP upper limit used at your institution? 2. What is the source of this upper limit? 3. Do you adjust your upper limit according to age? RESULTS: A total of 473 unique responses were obtained from North America (37.5%), South America (5.5%), Europe (29.4%), Africa (4%), Asia (21.6%) and Oceania (1.7%). A strong preponderance (86.8%) of institutions reported an upper limit of 0.45 g/L or less. Only 4% reported making age-partitioned adjustments. CONCLUSIONS: Worldwide, a strong majority of hospital laboratories presently use an underestimation of CSF-TP upper reference value, particularly for older adults. Recent well powered laboratory reference studies support higher values with age adjustment.
Authors: Pierre R Bourque; John Brooks; Jodi Warman-Chardon; Harald Hegen; Florian Deisenhammer; Chris R McCudden; Ari Breiner Journal: Data Brief Date: 2019-03-07
Authors: Pierre R Bourque; John Brooks; Christopher R McCudden; Jodi Warman-Chardon; Ari Breiner Journal: Neurol Neuroimmunol Neuroinflamm Date: 2019-05-21
Authors: Klaus Berek; Gabriel Bsteh; Michael Auer; Franziska Di Pauli; Anne Zinganell; Thomas Berger; Florian Deisenhammer; Harald Hegen Journal: Front Immunol Date: 2021-06-17 Impact factor: 7.561