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Pragmatic and evidence-based approach to paediatric cerebrospinal fluid reference limits for white cell count and

Nicky Josman1, Nancy W S Tee1, Matthias Maiwald1

  • 1Department of Pathology and Laboratory Medicine, KK Women's and Children's Hospital, Singapore, Singapore.

Journal of Clinical Pathology
|June 17, 2018
PubMed

Insights

Establishing pediatric reference intervals for cerebrospinal fluid (CSF) analysis is challenging. This study verified consensus CSF intervals for white cell count, protein, and glucose in children, providing practical guidelines.

Area of Science:

  • Clinical Chemistry
  • Paediatric Laboratory Medicine
  • Cerebrospinal Fluid (CSF) Analysis

Background:

  • Establishing unique paediatric reference intervals is often impractical for individual laboratories.
  • This challenge is amplified for invasive specimen types like cerebrospinal fluid (CSF).

Purpose of the Study:

  • To review and establish consensus paediatric reference intervals for key CSF parameters.
  • To verify these consensus intervals for local use in a paediatric hospital setting.

Main Methods:

  • Stakeholders reviewed published CSF reference intervals for white cell count, total protein, and glucose.
  • Consensus intervals were established and subsequently verified using Clinical Laboratory Standards Institute guidelines and residual CSF specimens.

Main Results:

  • Verified paediatric reference intervals for CSF white cell count (cells/µL): 0-20 (<1 month), 0-10 (1-2 months), 0-5 (>2 months).
  • Verified paediatric reference intervals for CSF total protein (g/L): 0.3-1.2 (<1 month), 0.2-0.6 (1-3 months), 0.1-0.4 (>3 months).
  • Verified paediatric reference intervals for CSF glucose (mmol/L): 2.0-5.6 (<6 months), 2.4-4.3 (≥6 months).

Conclusions:

  • Locally verified, consensus paediatric reference intervals for CSF analysis are practical and reliable.
  • These intervals support accurate interpretation of CSF parameters in paediatric patients.
Abstract

Keywords:
CSF biochemistrypaediatric chemistry

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