Scientific Publications Database

Article Title: Adult CSF total protein: Higher upper reference limits should be considered worldwide. A web-based survey
Authors: Bourque, Pierre R.; Breiner, Ari; Moher, David; Brooks, John; Hegen, Harald; Deisenhammer, Florian; McCudden, Christopher R.
Journal: JOURNAL OF THE NEUROLOGICAL SCIENCES Volume 396
Date of Publication:2019
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/%). 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.