Cerebrospinal fluid analysis: disease-related data patterns and evaluation programs.
Cerebrospinal fluid (CSF) analysis is a basic tool for diagnosis of neurological diseases. Knowledge regarding blood-CSF barrier function (molecular flux/CSF flow theory) and neuroimmunology is reviewed to aid understanding and evaluation of CSF data. Disease-related immunoglobulin patterns (IgG, IgA, IgM with reference to albumin) are described in CSF/serum quotient diagrams with the hyperbolic reference range for blood-derived protein fractions in CSF. Clinical relevance of complementary analyses (cytology, PCR, oligoclonal IgG, antibody detection and brain-derived proteins) is briefly discussed. Integrated CSF data reports are shown with numerical and graphical data representation, reference range-related interpretation and diagnosis-related comments. The principles and rationale of general CSF analysis reported in this review should enable the reader to accurately interpret CSF data profiles, and to plan a proper evaluation of new brain- or blood-derived analytes in CSF.
Neurochemistry Laboratory, University Göttingen, Robert-Koch-Strasse 40, D-37075 Göttingen, Germany. hreiber@med.uni-goettingen.de
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D000418:Albumins / Q000134:cerebrospinal fluid*; D001327:Autoimmune Diseases / Q000134:cerebrospinal fluid*; D001424:Bacterial Infections / Q000134:cerebrospinal fluid*; D014408:Biomarkers, Tumor / Q000134:cerebrospinal fluid*; D020805:Central Nervous System Viral Diseases / Q000134:cerebrospinal fluid; D002556:Cerebrospinal Fluid Proteins / Q000134:cerebrospinal fluid*; D006801:Humans; D007136:Immunoglobulins / Q000134:cerebrospinal fluid*; D020852:Lyme Neuroborreliosis / Q000134:cerebrospinal fluid; D016920:Meningitis, Bacterial / Q000134:cerebrospinal fluid; D009422:Nervous System Diseases / Q000134:cerebrospinal fluid; D019636:Neurodegenerative Diseases / Q000134:cerebrospinal fluid; D009494:Neurosyphilis / Q000134:cerebrospinal fluid
D000418:Albumins; D014408:Biomarkers, Tumor; D002556:Cerebrospinal Fluid Proteins; D007136:Immunoglobulins