14-3-3 testing in diagnosing Creutzfeldt-Jakob disease: a prospective study in 112 patients.
OBJECTIVE
To study the sensitivity and specificity of 14-3-3 testing in a prospective series of patients suspected of having Creutzfeldt-Jakob disease (CJD).


BACKGROUND
The 14-3-3 protein immunoassay on CSF has favorable test characteristics as a premortem diagnostic tool in CJD. However, the 14-3-3 protein is a normal cellular protein expressed in various tissues, and its presence in CSF reflects extensive destruction of brain tissue as in CJD, but also in ischemic stroke and meningoencephalitis.


METHODS
14-3-3 was tested in the CSF of a prospective series of 110 consecutive patients suspected of having CJD.


RESULTS
The sensitivity was 97% and the specificity was 87% in this series. False-positive results were mainly caused by stroke and meningoencephalitis.


CONCLUSIONS
The 14-3-3 protein is a highly sensitive and specific marker for CJD when used in the appropriate clinical context.
Lemstra
A W
AW
Department of Neurology, Academic Medical Center, University of Amsterdam, The Netherlands. a.w.lemstra@amc.uva.nl
van Meegen
M T
MT
Vreyling
J P
JP
Meijerink
P H
PH
Jansen
G H
GH
Bulk
S
S
Baas
F
F
van Gool
W A
WA
D048948:14-3-3 Proteins; D000328:Adult; D000368:Aged; D001254:Astrocytoma / Q000134:cerebrospinal fluid / Q000175:diagnosis*; D015415:Biomarkers / Q000134:cerebrospinal fluid; D001927:Brain Diseases / Q000134:cerebrospinal fluid / Q000175:diagnosis; D001932:Brain Neoplasms / Q000134:cerebrospinal fluid / Q000175:diagnosis*; D002555:Cerebrospinal Fluid / Q000737:chemistry; D007562:Creutzfeldt-Jakob Syndrome / Q000134:cerebrospinal fluid / Q000175:diagnosis*; D003937:Diagnosis, Differential; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D008223:Lymphoma / Q000134:cerebrospinal fluid / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011506:Proteins / Q000032:analysis*; D012680:Sensitivity and Specificity; D014446:Tyrosine 3-Monooxygenase
D048948:14-3-3 Proteins; D015415:Biomarkers; D011506:Proteins; D014446:Tyrosine 3-Monooxygenase