title: Diagnosis of cerebral amyloid angiopathy by enzyme-linked immunosorbent assay of cystatin C in cerebrospinal fluid.
abstract: An abnormally low level of cystatin C in the cerebrospinal fluid is a diagnostic marker for the hereditary form of brain hemorrhage associated with amyloidosis that was first identified in Iceland. We developed an assay for cystatin C to use in the diagnosis of patients with cerebral amyloid angiopathy and brain hemorrhage. This test consists of a sandwich enzyme-linked immunosorbent assay using monoclonal mouse anticystatin C and polyclonal rabbit anticystatin C antibodies. The cystatin C level was assayed in cerebrospinal fluid samples from 29 patients with brain hemorrhage and 45 control patients with other neurological diseases. Fifteen patients with brain hemorrhage showed low cystatin C levels (less than or equal to 70 ng/ml) in a clinical setting in which the positive and negative findings were compatible with a diagnosis of cerebral amyloid angiopathy. Immunohistological examination of brain tissue obtained by biopsy from two of the 15 patients confirmed the diagnosis of cerebral amyloid angiopathy and identified the deposition of cystatin C and beta-protein. This enzyme-linked immunosorbent assay is simple to perform and may be useful for investigating patients suspected of having cerebral amyloid angiopathy with brain hemorrhage and the deposition of cystatin C.
authors.affiliation: Third Division of Internal Medicine, Shimane Medical University, Izumo, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Shimode
authors.forename: S
authors.initials: S
authors.lastname: Fujihara
authors.forename: M
authors.initials: M
authors.lastname: Nakamura
authors.forename: S
authors.initials: S
authors.lastname: Kobayashi
authors.forename: T
authors.initials: T
authors.lastname: Tsunematsu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000686:Amyloidosis / Q000134:cerebrospinal fluid / Q000175:diagnosis*; D001921:Brain / Q000378:metabolism / Q000473:pathology; D002543:Cerebral Hemorrhage / Q000134:cerebrospinal fluid / Q000175:diagnosis*; D002556:Cerebrospinal Fluid Proteins / Q000032:analysis; D003224:Congo Red; D055316:Cystatin C; D015891:Cystatins / Q000134:cerebrospinal fluid*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged
chemical_list: C525030:CST3 protein, human; D002556:Cerebrospinal Fluid Proteins; C525031:Cst3 protein, mouse; D055316:Cystatin C; D015891:Cystatins; D003224:Congo Red