Mayo Test Catalog, (Sorted By Test Name) - Mayo Medical ...

TPSF
872
PTU
8261
Reference values have not been established for patients that are less than 12 months of age.
Clinical References: 1. Tietz Textbook of Clinical Chemistry. Edited by CABurtis, ER Ashwood.
Philadelphia, WB Saunders Company, 1994 2. Killingsworth LM: Plasma proteins in health and
disease. Crit Rev Clin Lab Sci 1979;11:1-30
Protein, Total, Spinal Fluid
Clinical Information: Cerebral spinal fluid (CSF) is secreted by the choroid plexuses, around the
cerebral vessels, and along the walls of the ventricles of the brain. It fills the ventricles and cisternae,
bathes the spinal cord, and is reabsorbed into the blood through the arachnoid villi. CSF turnover is
rapid, exchanging about four times per day. More than 80% of CSF protein content originates from
plasma by ultrafiltration through the walls of capillaries in the meninges and choroid plexuses; the
remainder originates from intrathecal synthesis. Because CSF is mainly an ultrafiltrate of plasma,
low-molecular plasma proteins such as prealbumin, albumin, and transferrin predominate. No protein
with a molecular weight greater than that of IgG is present in sufficient concentration to be visible on
electrophoresis. The permeability of the blood-brain barrier to plasma proteins is increased by high
intracranial pressure due to brain tumor; intracerebral hemorrhage; traumatic injury; or by inflammation
due to bacterial or viral meningitis, encephalitis, or poliomyelitis. Increased intrathecal synthesis of
immunoglobulins, particularly IgG, is seen in demyelinating diseases of the central nervous system
(CNS), especially multiple sclerosis. Increased immunoglobulins are also seen in other chronic
inflammatory diseases of the CNS such as chronic meningoencephalitis due to bacteria, viruses, fungi or
parasites; subacute sclerosing panencephalitis; and Guillian-Barre syndrome.
Useful For: To detect increased permeability of the blood-brain barrier to plasma proteins To detect
increased intrathecal production of immunoglobulins
Interpretation: Striking elevations of CSF total protein are noted in bacterial meningitis; smaller
elevations occur in the other inflammatory diseases and with tumor or hemorrhage. The effect of any of
these conditions is that the proportions of specific proteins in CSF increasingly resemble serum. In order
to assess increased permeability or increased intrathecal production of proteins, simultaneous serum
specimen and CSF specimens should be taken.
Reference Values:
> or =12 months: 0-35 mg/dL
Reference values have not been established for patients that are 500 mg/24 hours should be evaluated by immunofixation to
determine if a monoclonal immunoglobulin light chain is present, and if so, identify it as either kappa or
lambda type. Urinary protein levels may rise to 300 mg/24 hours in healthy individuals after vigorous
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