Nejvíce citovaný článek - PubMed ID 11213505
Cerebrospinal fluid cytologic findings in multiple sclerosis. A comparison between patient subgroups
AIMS: This study compared the results obtained by basic immunophenotyping of cerebrospinal fluid (CSF) cells by flow cytometry (FC) to the results of conventional cytology and evaluated the possibility of detailed analyses of CSF B-cell subpopulations. METHODS: Samples from 42 patients were examined by conventional cytology (native and/or pre-centrifuged CSF) and FC. The results from 15 patients without evidence of organic neurological disease were used to estimate reference ranges. RESULTS: Pre-centrifugated CSF had significantly higher cell yield on the cytologic slide, but cell subpopulation percentages were altered; the percentage of lymphocytes was significantly higher and monocytes significantly lower compared to both native CSF slides and FC. The percentage of granulocytes was higher in FC compared to cytology. For leukocyte count, the following reference ranges were estimated for Fuchs-Rosenthal chamber (FR) counting and FC, respectively: leukocytes ≤4.7/μL and ≤2.5/μL, lymphocytes ≤4.1/μL and ≤1.8/μL, monocytes ≤1.2/μL and ≤0.9/μL, and granulocytes 0/μL and ≤0.2/μL. The following reference ranges were estimated for basic subpopulations: T-lymphocytes 84.1-100%, B lymphocytes 0.0-1.5%, NK cells 0.0-6.3%, NKT cells 0-9.5%, and CD3+CD4+/CD3+CD8+ 0.8-4.9. Using a volume of 1.2-2.4 mL, the number of B lymphocytes was too low (<20) in samples with ≤2.7 cells/μL in the FR. CONCLUSIONS: Even normal CSF samples are amenable to basic mononuclear cell subpopulation analysis by FC. However, analysis of the B-cell subpopulations requires either a larger sample volume or selection of samples with ≥ 3 cells/μL.
- Klíčová slova
- B lymphocytes, cerebrospinal fluid, cytology, flow cytometry,
- MeSH
- imunofenotypizace MeSH
- leukocyty * MeSH
- lidé MeSH
- lymfocyty * MeSH
- mozkomíšní mok MeSH
- průtoková cytometrie metody MeSH
- T-lymfocyty MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
Diseases of the central nervous system (CNS) mean for the human organism a potentially dangerous situation. An investigation of cerebrospinal fluid (CSF) provides important information about a character of CNS impairment in the decision-making diagnostic and therapeutic algorithm. The authors present a brief overview of available cerebrospinal fluid assays, shortened indication criteria, a recommended algorithm of CSF assessment in different suspected diseases, and a view of the external quality system. The whole portfolio of obtainable CSF methodology is further subdivided according to the adequate choice into the first and inevitable basic routine panel, and following complicated analyses of highly specialized character. The basic panel is considered for standard laboratories, the complete specialized assessment should be provided by a super-consulting laboratory.
- MeSH
- algoritmy MeSH
- cytologické techniky MeSH
- klinické laboratorní techniky MeSH
- lidé MeSH
- makrofágy MeSH
- mozkomíšní mok chemie cytologie MeSH
- proteiny v mozkomíšním moku analýza MeSH
- směrnice pro lékařskou praxi jako téma * MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
- Názvy látek
- proteiny v mozkomíšním moku MeSH
OBJECTIVES: In tumorous impairment of CNS, cytological identification of the neoplastic cells in CSF frequently requires the use of ancillary techniques. Our methods are focused on identifying algorithms that increase the probability of identifying CSF malignant cells. MATERIALS AND METHODS: A total of 1.272 CSF samples from patients with tumorous infiltration of CNS of nonhematologic origin along with 721 samples from patients with hematologic malignancies were analyzed in a complex setting including cytological and immunocytochemical investigations. RESULTS AND DISCUSSION: In CSF diagnostics we are aware of the limited amount of sample combined frequently with neoplastic oligocytosis. Provided atypical, potentially malignant cells in CSF are found, further investigation(s) should maximize the probability of their identification-an appropriate cytological staining and immunocytochemical panel is to be applied. (i) In cases of known recent malignancy: immunoprofile of the recent neoplasm has been considered in immunocytochemical panel. (ii) In patients with a history of malignancy: The propensity to develop a new different malignancy must be taken into account. (iii) Atypical cells found in the CSF of a patient with a negative history of malignancy: Considering the most frequent clinically silent malignancies, stepwise immunocytochemistry is employed. Three milliliter of initial CSF sample represents the absolute minimum to start with. CONCLUSIONS: The steps of the laboratory activity targeted on malignancy in the CSF detection can be expected as follows: (i) The sample will be divided for both nonmorphology and cytopathology investigations. (ii) Basic stainings will triage the samples into those with no suspicion of malignancy and the remaining ones. (iii) Special stainings and stepwise immunocytochemistry will be performed in parallel with the nonmorphology investigations.
- Klíčová slova
- cerebrospinal fluid, cytology, immunocytochemistry, malignant cells,
- MeSH
- dospělí MeSH
- imunohistochemie metody MeSH
- lidé středního věku MeSH
- lidé MeSH
- mozkomíšní mok diagnostické zobrazování MeSH
- nádory centrálního nervového systému * mozkomíšní mok diagnóza metabolismus MeSH
- neurologické vyšetření metody MeSH
- počet buněk metody MeSH
- reprodukovatelnost výsledků MeSH
- senioři MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
The levels of prealbumin (PAB, transthyretin) were determined and evaluated in the cerebrospinal fluid (CSF) and serum in various subgroups of the multiple sclerosis (MS) patients. In severely disabled patients, serum PAB was elevated more frequently. CSF and serum PAB concentrations were higher in treated than in nontreated patients; the values above the upper reference limits were also more frequently found in treated patients. PAB index showed a tendency to decrease during the course of the disease. The routine determination of PAB in CSF and serum is, therefore, recommended to be recognized in MS patients as a substantial clinical value and, thus, be comprised, including also immunoglobulins and other parameters, into the spectrum of characteristics in Protein Panel.
- MeSH
- lidé MeSH
- prealbumin analýza mozkomíšní mok MeSH
- roztroušená skleróza krev mozkomíšní mok patologie MeSH
- stupeň závažnosti nemoci MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- srovnávací studie MeSH
- Názvy látek
- prealbumin MeSH
Selected cerebrospinal-fluid (CSF) parameters (intrathecal synthesis of Borrelia-specific antibodies, oligoclonal IgG bands, CSF-to-serum quotient of albumin as a marker of blood-CSF barrier function and cytology) and typical CSF profile in neuroborreliosis were evaluated with the aim of elucidating possible clinical and laboratory similarities of neuroborreliosis (NB) and other neurological diseases (OND). From the cohort of 58 patients (38 diagnosed for NB, 20 with OND) NB patients had positive Borrelia-specific IgG antibodies in 97 % and positive Borrelia-specific IgM antibodies in 55 %; oligoclonal IgG bands were detected in 55%. The blood-CSF barrier was impaired in 89%, positive cytology was detected in 97% of the NB patients. Evaluation of specific intrathecal synthesis improves CSF diagnosis of NB, therefore, a combined CSF analysis has to be considered along with the clinical picture and medical history when formulating the diagnosis of NB.
- MeSH
- Borrelia burgdorferi komplex * imunologie MeSH
- diferenciální diagnóza MeSH
- hematoencefalická bariéra MeSH
- histocytochemie MeSH
- imunoglobulin G mozkomíšní mok MeSH
- imunoglobulin M mozkomíšní mok MeSH
- lidé MeSH
- lymská neuroborelióza mozkomíšní mok diagnóza MeSH
- mozkomíšní mok * chemie cytologie imunologie MeSH
- nemoci nervového systému mozkomíšní mok diagnóza MeSH
- protilátky bakteriální mozkomíšní mok MeSH
- sérový albumin mozkomíšní mok MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- Názvy látek
- imunoglobulin G MeSH
- imunoglobulin M MeSH
- protilátky bakteriální MeSH
- sérový albumin MeSH
In a group of 10,156 patients with neurological diseases, the IgM level was assessed (using laser nephelometry) both in cerebrospinal fluid (CSF) and serum; concentration of other 17 protein fractions was also simultaneously determined: albumin, immunoglobulins, acute phase reactants, complement components, apolipoproteins, proteinase inhibitors and alpha1-microglobulin. Total protein, element counts and glucose level were also evaluated. In patients with normal CSF findings, only limited statistically significant correlations were demonstrated between IgM and other CSF protein fractions while, in the group of patients with pathological CSF findings, significant correlations were found between CSF(IgM) and other immunoglobulins, complement fractions and the rate of intrathecal synthesis of immunoglobulins. Correlations were also found between CSF(IgM) and CSF antithrombin-III and alpha1-microglobulin. Correlations between CSF(IgM) and CSF apolipoproteins support the theory of CNS tissue destruction whenever the concentration of CSF apolipoproteins is elevated. Our data substantially contribute to establishing the diagnosis in patients with neurological diseases; simultaneous measurement of a high number of CSF proteins is becoming inevitable for a reasonable assessment of the CSF Protein Status.
- MeSH
- biologické markery MeSH
- imunoglobulin M krev mozkomíšní mok MeSH
- lidé MeSH
- lineární modely MeSH
- mozkomíšní mok chemie cytologie imunologie MeSH
- nemoci nervového systému krev mozkomíšní mok imunologie MeSH
- prediktivní hodnota testů MeSH
- proteiny v mozkomíšním moku chemie MeSH
- zánět MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Názvy látek
- biologické markery MeSH
- imunoglobulin M MeSH
- proteiny v mozkomíšním moku MeSH
Contemporary aspects of cerebrospinal fluid analysis are discussed, including the relationship to neuro-infective, autoimmune and other neurological diseases. The actual state of cerebrospinal fluid microbiological and cytological investigation and analysis of cerebrospinal fluid protein fractions are described in detail.
