Protein Electrophoresis, Cerebrospinal Fluid

TEST: 002246
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CPT: 84157; 84166
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Synonyms

  • CSF Electrophoresis
  • Electrophoresis, CSF
  • Globulins, CSF
  • Spinal Fluid Electrophoresis

Test Includes

Total protein CSF; determination of proteins seen in the electrophoresis; densitometric scan

Expected Turnaround Time

4 - 7 days

Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary.

Related Information

Related Documents

For more information, please view the literature below.

Published Plasma Cell Dyscrasias Selection Table

Specimen Requirements

Specimen

Cerebrospinal fluid (CSF)

Volume

2 mL

Minimum Volume

1.2 mL (Note: This volume does not allow for repeat testing.)

Container

Sterile tube

Collection

The third tube of a routinely obtained three-tube set of CSF should be used for protein electrophoretic study.

Storage Instructions

Refrigerate at 2°C to 8°C.

Stability Requirements

Temperature

Period

Refrigerated

3 days (stability provided by manufacturer or literature reference)

Frozen

1 month (stability provided by manufacturer or literature reference)

Causes for Rejection

Gross hemolysis

Test Details

Use

Quantitate CSF protein fractions; aid in the diagnosis of inflammatory and demyelinating disease of CNS, although routine CSF protein electrophoresis is highly insensitive and nonspecific for the presence of multiple sclerosis (MS). Routine CSF protein electrophoresis has no role in screening for demyelinating diseases (eg, MS). For this, high-resolution electrophoresis is required. For tests with greater sensitivity/specificity for MS, see Oligoclonal Banding [019216].

Methodology

Electrophoresis on agarose media

Reference Interval

See tables.

CSF Protein Electrophoresis

Test

Age

Male

Female

Prealbumin (%)

0 to 1 y

1.1–5.7

1.1–5.7

2 to 17 y

2.2–7.8

2.2–7.8

18 to 30 y

1.4–6.3

2.2–7.7

31 to 50 y

1.2–5.5

1.9–7.1

51 to 60 y

1.2–5.5

1.4–6.2

>60 y

1.0–5.0

1.4–6.2

Albumin (%)

All ages

47.8–69.1

47.8–69.1

α1-globulin (%)

0 to 5 y

2.1–5.6

2.1–5.6

6 to 60 y

2.2–6.2

2.2–6.2

>60 y

2.6–7.0

2.6–7.0

α2-globulin (%)

0–50 y

2.7–8.2

2.7–8.2

>50 y

3.1–8.7

3.1–8.7

β-globulin (%)

All ages

11.8–21.7

11.8–21.7

γ-globulin (%)

0 to 17 y

2.8–7.8

2.8–7.8

18 to 40 y

2.4–7.8

2.8–8.5

41 to 60 y

2.8–8.5

2.8–8.5

>60 y

2.8–8.5

3.1–9.1

Total protein (mg/dL)

1 d to 1 m

25–72

25–72

2 to 3 m

20–72

20–72

4 to 6 m

15–50

15–50

7 to 11 m

10–45

10–45

1 to 2 y

10–40

10–40

3 to 4 y

10–38

10–38

5 to 8 y

10–43

10–43

>8 y

0–44

0–44

CSF Protein Electrophoresis Interpretation

Pattern Description

Electrophoretic Zones

Prealbumin

(g/dL)

Albumin

(g/dL)

α1

(g/dL)

α2

(g/dL)

β

(g/dL)

γ

(g/dL)

N = usually normal.

(+) = usually elevated.

N+ = normal to elevated.

+ = mildly elevated.

++ = moderately elevated.

+++ = markedly elevated.

Normal

N

N

N

N

N

N

Increased prealbumin

+++

N

N

N

N

N

Increased permeability

++

++

++

++

++

++

Polyclonal gammopathy

+

N+

+

N

++

Monoclonal gammopathy

N+

N

N

N+

(M-spike)

(M-spike)

Nonspecific α-β increases

N

N

(+)

(+)

(+)

N

Additional Information

Severe craniocerebral trauma is characterized by a three- to fourfold increase in α2 globulins during the first week post trauma.

LOINC® Map

Order Code Order Code Name Order Loinc Result Code Result Code Name UofM Result LOINC
002246 Protein Electrophoresis, CSF 24352-7 002055 Protein, Total, CSF mg/dL 2880-3
002246 Protein Electrophoresis, CSF 24352-7 122200 Pre-Albumin, CSF % 13973-3
002246 Protein Electrophoresis, CSF 24352-7 122218 Albumin, CSF % 13974-1
002246 Protein Electrophoresis, CSF 24352-7 122226 Alpha-1-Globulin, CSF % 13972-5
002246 Protein Electrophoresis, CSF 24352-7 122234 Alpha-2-Globulin, CSF % 13975-8
002246 Protein Electrophoresis, CSF 24352-7 122242 Beta Globulin, CSF % 13976-6
002246 Protein Electrophoresis, CSF 24352-7 122259 Gamma Globulin, CSF % 13977-4
002246 Protein Electrophoresis, CSF 24352-7 122367 M-Spike % 12782-9
002246 Protein Electrophoresis, CSF 24352-7 122370 PDF 11502-2

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