Related Experiment Video
Updated: Jun 6, 2026
05:43
Real-Time Dynamic Collection of Hippocampal Extracellular Fluid from Conscious Rats Using a Microdialysis System
Published on: October 21, 2022
Cerebrospinal fluid under non-steady state condition caused by plasmapheresis
Dominik Madžar1, Christian Maihöfner, Rüdiger Zimmermann
1Department of Neurology, Universitätsklinikum Erlangen, Schwabachanlage 6, 91054, Erlangen, Germany.
Journal of Neural Transmission (Vienna, Austria : 1996)
|November 16, 2010
Summary
Plasmapheresis can alter protein diffusion, leading to misinterpretation of Guillain-Barré syndrome biomarkers. Careful analysis of cerebrospinal fluid (CSF) and serum biomarkers is crucial for accurate diagnosis.
Area of Science:
- Neurology
- Clinical Chemistry
- Biochemistry
Background:
- Guillain-Barré syndrome (GBS) diagnosis relies on cerebrospinal fluid (CSF) and serum biomarker analysis.
- Plasmapheresis, a treatment for GBS, can induce unsteady-state protein diffusion, potentially affecting biomarker interpretation.
Observation:
- An unusual pattern of CSF/serum biomarkers was observed in a GBS patient undergoing plasmapheresis.
- Low serum immunoglobulin concentrations with normal CSF levels led to seemingly increased CSF/serum quotients, mimicking an intrathecal humoral response.
Findings:
- Isoelectrofocusing revealed identical IgG banding patterns in CSF and serum, contradicting the apparent intrathecal response.
- Biomarker quotients normalized six weeks after plasmapheresis cessation, confirming the transient effect of the treatment.
Implications:
- CSF/serum biomarker analysis during non-steady-state conditions, such as post-plasmapheresis, can be easily misinterpreted.
- Comprehensive evaluation of all CSF/serum biomarkers is essential for accurate GBS diagnosis and management.
Related Concept Videos
01:21Cerebrospinal Fluid
Cerebrospinal fluid (CSF) is a colorless liquid that flows around the brain and the spinal cord, playing a vital role in the protection, support, and overall function of the central nervous system (CNS). CSF production, circulation, and absorption are tightly regulated processes essential for the brain and spinal cord to function properly.
CSF Production
CSF is produced mainly in the choroid plexus, a network of capillaries and ependymal cells located within the ventricular system of the brain.
CSF Production
CSF is produced mainly in the choroid plexus, a network of capillaries and ependymal cells located within the ventricular system of the brain.
01:22Cerebral Edema ll: Pathophysiology
Vasogenic edema is a major form of cerebral edema characterized by abnormal accumulation of fluid in the brain’s extracellular space due to disruption of the blood–brain barrier (BBB). The BBB is a specialized structure composed of endothelial cells connected by tight junctions, supported by astrocytic endfeet and a basement membrane. Under normal conditions, it tightly regulates the movement of ions, proteins, and solutes between the bloodstream and brain parenchyma. When this barrier loses...
01:19Cerebral Edema l: Introduction
Cerebral edema is a pathological increase in brain water content that disrupts intracranial pressure regulation and impairs neurological function. Because the cranial vault is rigid, even modest increases in tissue volume can compromise cerebral perfusion, distort neural structures, and initiate secondary injury. Cerebral edema develops through four principal mechanisms: vasogenic, cytotoxic, interstitial, and ionic.Vasogenic EdemaVasogenic edema arises from disruption of the blood–brain...
01:21Cytotoxic Edema: Pathophysiology
Cytotoxic edema is a form of cerebral edema characterized by intracellular swelling of neurons, astrocytes, and other glial cells. It develops when the mechanisms responsible for maintaining ionic gradients across the cell membrane become impaired. Under normal physiological conditions, the sodium–potassium ATPase actively transports sodium ions out of the cell and potassium ions into the cell, preserving osmotic balance and enabling electrical signaling. This pump requires a continuous supply...
01:29Hemorrhagic Stroke ll: Pathophysiology
A hemorrhagic stroke develops when a cerebral blood vessel ruptures, allowing blood to escape into the surrounding brain tissue, as in intracerebral hemorrhage (ICH), or into the subarachnoid space, as in subarachnoid hemorrhage (SAH). Because the skull is a rigid compartment, the sudden presence of extravascular blood rapidly increases intracranial pressure and compresses adjacent neural structures, leading to immediate tissue injury and impaired cerebral perfusion.Mass Effect and Primary...
01:29Increased Intracranial Pressure ll: Pathophysiology
Increased intracranial pressure (ICP) refers to a potentially life-threatening rise in pressure inside the skull. This usually happens when there is a major change in the volume of brain tissue, blood, or cerebrospinal fluid (CSF) — the three components inside the skull. According to the Monro-Kellie doctrine, if the volume of one component increases, the volumes of the other components must decrease to maintain normal pressure. If this does not happen, ICP rises.The process often begins with...