Detection of spinal fluid in body fluids, such as ear or nasal fluid.
The diagnosis of cerebrospinal fluid (CSF) rhinorrhea or otorrhea (leakage of CSF into the nose or ear canal, usually as a result of head trauma, tumor, congenital malformation, or surgery) is often difficult to confirm. Traditional chemical analyses (eg, glucose, protein, specific gravity) are unreliable. Radiographic studies, especially those involving the injection of dyes or radiographic compounds, are costly and may introduce additional risks to the patient.
Transferrin that migrates in the beta-1 electrophoretic fraction (beta-1 transferrin) is found in most body fluids. Beta-2 transferrin is a CSF-specific variant of transferrin and is used as an endogenous marker of CSF leakage. Beta-2 transferrin is formed by loss of sialic acid due to the presence of neuraminidase in the central nervous system. Beta-2 transferrin has also been called CSF-specific transferrin and tau protein.
Prompt diagnosis and localization facilitates appropriate decisions and decreases the risk of meningitis.
Beta 2 Transferrin
Specimens should be collected on one occasion and should preferably be larger than 0.05 mL. Samples should be collected without the use of swabs, especially if the volume of sample is low, or particularly viscous, as the swabs tend to absorb the moisture making the sample difficult to extract for analysis.
If the sample is being sent in a syringe, please ensure the needle is removed and the end of the syringe is capped.
Though 0.05 mL is usually sufficient to perform the test, in some instances the determination of tau-transferrin may be unclear and a repeat sample may be requested.
Ambient (8 - 24 degrees Celsius)
Results are in form of interpretive comment, as below:
POSITIVE results: Tau transferrin DETECTED, consistent with the presence of CSF.
NEGATIVE results: As tau-transferrin was NOT detected there is no evidence to support the presence of CSF.
Specimens are electrophoresed using a high resolution 1% agarose gel, followed by immunofixation with antiserum to human transferrin.
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