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Cerebrospinal fluid protein concentrations in children: age-related values in patients without disorders of the
D Biou1, J F Benoist, C Nguyen-Thi
1Service de Biochemie-Hormonologie, Hôpital Pèdiatrique Robert Debré, Paris, France. daniel.adrbp@wanadoo.fr
Insights
New reference values for cerebrospinal fluid (CSF) total protein in children are established using dry chemistry methods. These findings highlight the need for age-specific interpretation, especially in infants, to ensure accurate diagnoses.
Area of Science:
- Clinical Chemistry
- Pediatric Neurology
- Laboratory Medicine
Background:
- Existing cerebrospinal fluid (CSF) total protein reference values for children have limitations, including broad age ranges and a lack of data for dry chemistry methods.
- Accurate interpretation of CSF protein is crucial for diagnosing pediatric neurological conditions.
Purpose of the Study:
- To establish age-specific reference values for CSF total protein concentrations in children using a dry chemistry method.
- To address the limitations of current reference ranges, particularly for early infancy.
Main Methods:
- A retrospective survey of CSF results from 1074 children and term neonates was conducted over two years.
- A dry chemistry-based method on the Vitros 700 analyzer was utilized for CSF analysis.
Main Results:
- Seven distinct age groups with significantly different CSF protein values were identified.
- CSF protein concentrations rapidly decrease from birth to 6 months (1.08 to 0.40 g/L), plateau from 6 months to 10 years (0.32 g/L), and slightly increase from 10-16 years (0.41 g/L).
- Age-related percentiles (5th, 50th, 95th) were determined for each group.
Conclusions:
- Pediatric CSF total protein concentrations require interpretation within narrow, age-specific reference ranges.
- Utilizing these new values can help avoid false-positive results, improving diagnostic accuracy in children, especially infants.
Background:
The published reference values for cerebrospinal fluid (CSF) total protein concentrations in children suffer from two major drawbacks: (a) the age-related range often is too broad when applied to the steeply falling concentrations in early infancy; and (b) no values have been published for widely used dry chemistry methods.
Methods:
We conducted a 2-year retrospective survey of CSF results obtained in a children's hospital with a dry chemistry-based method set up on the Vitros 700 analyzer.
Results:
The data related to ambulatory children up to 16 years of age and term neonates with no clinical or biological signs of brain disease (n = 1074). Seven age groups with significantly different CSF protein values were identified, and their age-related percentiles (5th, 50th, and 95th) were determined. On the basis of the upper 95th percentile, from age 0 to 6 months the CSF protein concentrations fell rapidly from 1.08 to 0.40 g/L. A plateau (0.32 g/L) was reached from age 6 months to 10 years, followed by a slight increase (0.41 g/L) in the 10-16 years age range.
Conclusions:
These results imply that CSF total protein concentrations in the pediatric setting, particularly in infants, must always be interpreted with regard to narrow age-related reference values to avoid false-positive results.
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