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14-3-3 testing in diagnosing Creutzfeldt-Jakob disease: a prospective study in 112 patients
A W Lemstra1, M T van Meegen, J P Vreyling
1Department of Neurology, Academic Medical Center, University of Amsterdam, The Netherlands. a.w.lemstra@amc.uva.nl
Objective:
To study the sensitivity and specificity of 14-3-3 testing in a prospective series of patients suspected of having Creutzfeldt-Jakob disease (CJD).
Background:
The 14-3-3 protein immunoassay on CSF has favorable test characteristics as a premortem diagnostic tool in CJD. However, the 14-3-3 protein is a normal cellular protein expressed in various tissues, and its presence in CSF reflects extensive destruction of brain tissue as in CJD, but also in ischemic stroke and meningoencephalitis.
Methods:
14-3-3 was tested in the CSF of a prospective series of 110 consecutive patients suspected of having CJD.
Results:
The sensitivity was 97% and the specificity was 87% in this series. False-positive results were mainly caused by stroke and meningoencephalitis.
Conclusion:
The 14-3-3 protein is a highly sensitive and specific marker for CJD when used in the appropriate clinical context.