Routine Cerebrospinal Fluid (CSF) Analysis

Deisenhammer, Florian; Bartoš, Aleš; Egg, R.; Gilhus, Nils Erik; Giovannoni, Gavin; Rauer, Sebastian; Sellebjerg, Finn

doi:10.1002/9780470753279.ch4

Cited by 12 publications

(19 citation statements)

References 76 publications

(62 reference statements)

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“…9 One CSF sample was analysed per patient, as a part of their diagnostic process, and a differential leukocyte count was performed on the stained sample, when more than 6 or 20 leukocytes/L were observed, in adults and children, respectively.…”

Section: Methodsmentioning

confidence: 99%

Interleukin-6 in cerebrospinal fluid as a biomarker of acute meningitis

et al. 2015

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Background: Microbiological culture of cerebrospinal fluid is the gold standard to differentiate between aseptic and bacterial meningitis, but this method has low sensitivity. A fast and reliable new marker would be of interest in clinical practice.Objective: Interleukin-6, secreted by T cells in response to meningeal pathogens and quickly delivered into cerebrospinal fluid, was evaluated as a marker of acute meningitis. Results: Cerebrospinal fluid interleukin-6 concentration showed significant differences between all pathologic groups and the control group (P < 0.001). As a diagnostic tool for bacterial meningitis, interleukin-6 showed an area under the curve of 0.937 (95% confidence intervals: 0.895-0.978), significantly higher than those of classical biomarkers. An interleukin-6 cutoff of 1418 pg/mL showed 95.5% sensitivity and 77.5% specificity, whereas a value of 15,060 pg/mL showed 63.6% sensitivity and 96.7% specificity, for diagnosis of bacterial meningitis. Conclusion: Interleukin-6 measured by electrochemiluminescence method is a promising marker for early differentiation between aseptic and bacterial meningitis. More studies are needed to validate clinical implications for future practice in an emergency laboratory.

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Section: Methodsmentioning

confidence: 99%

Interleukin-6 in cerebrospinal fluid as a biomarker of acute meningitis

et al. 2015

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“…1,2 CSF samples must be delivered to the laboratory immediately and should be analysed within 1 h of collection. Routine assessment of CSF includes determination of protein, glucose and lactate concentrations.…”

Section: Introductionmentioning

confidence: 99%

“…Other tests may be useful depending on the presumptive diagnosis. 2,3 CSF is an ultrafiltrate of plasma, and CSF glucose concentration is regulated through facilitated transportation across the blood-brain barrier, with CSF glucose concentrations being proportional to plasma concentrations. 4,5 The normal CSF glucose concentration is approximately 50-60% of the blood glucose concentration, ranging from 2.2 to 3.9 mmol/L.…”

Section: Introductionmentioning

confidence: 99%

“…CSF glucose concentration, especially low glucose concentrations (representing a CSF/blood glucose ratio lower than 0.4) and increased lactate concentrations are useful in the diagnosis of neurological inflammatory diseases (especially bacterial or fungal meningitis), metastases and disorders with increased CSF cell count. 2 In contrast to a low CSF glucose concentration, the finding of a high CSF glucose concentration has no specific diagnostic significance. High CSF glucose concentration may be observed in patients with high plasma glucose concentrations, such as patients with diabetes.…”

Section: Introductionmentioning

confidence: 99%

“…Serous meningitis was diagnosed, with a mononuclear cell count of 300/mL (reference interval <15 cells/mL) and a polymorphonulcear cell count of 20/mL (reference interval <1 cell/mL). 2 The presence of lymphoma in meninges was excluded by FACS. Biochemical analysis of CSF revealed total protein concentration of 0.97 g/L (reference interval 0.15-0.25 g/L), 6 a high concentration of lactate (7.1 mmol/L; reference interval 1.4-2.6 mmol/L) 9 and an extremely high CSF glucose concentration (78.6 mmol/L).…”

Section: Introductionmentioning

confidence: 99%

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Two cases of spuriously elevated cerebrospinal glucose concentration

et al. 2014

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We present two cases of spuriously high cerebrospinal fluid glucose concentration with approximately normal blood glucose concentrations. The cause of these abnormal findings was the use of inappropriate collection tubes during the pre-analytical phase. Whilst no patient harm was identified following this error, significant time and effort were expended by both laboratory and clinical staff to explain the cause of these findings.

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Comprehensive RNA analysis of CSF reveals a role for CEACAM6 in lung cancer leptomeningeal metastases

Polyak

Lamsam

et al. 2021

npj Precis. Onc.

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Non-small cell lung cancer (NSCLC) metastatic to the brain leptomeninges is rapidly fatal, cannot be biopsied, and cancer cells in the cerebrospinal fluid (CSF) are few; therefore, available tissue samples to develop effective treatments are severely limited. This study aimed to converge single-cell RNA-seq and cell-free RNA (cfRNA) analyses to both diagnose NSCLC leptomeningeal metastases (LM), and to use gene expression profiles to understand progression mechanisms of NSCLC in the brain leptomeninges. NSCLC patients with suspected LM underwent withdrawal of CSF via lumbar puncture. Four cytology-positive CSF samples underwent single-cell capture (n = 197 cells) by microfluidic chip. Using robust principal component analyses, NSCLC LM cell gene expression was compared to immune cells. Massively parallel qPCR (9216 simultaneous reactions) on human CSF cfRNA samples compared the relative gene expression of patients with NSCLC LM (n = 14) to non-tumor controls (n = 7). The NSCLC-associated gene, CEACAM6, underwent in vitro validation in NSCLC cell lines for involvement in pathologic behaviors characteristic of LM. NSCLC LM gene expression revealed by single-cell RNA-seq was also reflected in CSF cfRNA of cytology-positive patients. Tumor-associated cfRNA (e.g., CEACAM6, MUC1) was present in NSCLC LM patients’ CSF, but not in controls (CEACAM6 detection sensitivity 88.24% and specificity 100%). Cell migration in NSCLC cell lines was directly proportional to CEACAM6 expression, suggesting a role in disease progression. NSCLC-associated cfRNA is detectable in the CSF of patients with LM, and corresponds to the gene expression profile of NSCLC LM cells. CEACAM6 contributes significantly to NSCLC migration, a hallmark of LM pathophysiology.

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Routine Cerebrospinal Fluid (CSF) Analysis

Cited by 12 publications

References 76 publications

Interleukin-6 in cerebrospinal fluid as a biomarker of acute meningitis

Interleukin-6 in cerebrospinal fluid as a biomarker of acute meningitis

Two cases of spuriously elevated cerebrospinal glucose concentration

Comprehensive RNA analysis of CSF reveals a role for CEACAM6 in lung cancer leptomeningeal metastases

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