Quality assurance for cerebrospinal fluid protein analysis: International consensus by an internet-based group discussion

Hansotto Reiber, Edward J. Thompson, Guy Grimsley, Gaetano Bernardi, Pavel Adam, Sergio Monteiro de Almeida, Pam Fredman, Geoffrey Keir, Manfred Lammers, Roland Liblau, Marcio Menna-Barreto, María José Sá, Erika Seres, Christian J M Sindic, Albert Teelken, Christian Trendelenburg, María Trojano, Marie Paule van Antwerpen, Marcel M. Verbeek

Research output: Contribution to journalArticlepeer-review

Abstract

A group of neurologists and clinical neurochemists representing twelve countries worked towards a consensus on laboratory techniques to improve the quality of analysis and interpretation of cerebrospinal fluid (CSF) proteins. Consensus was approached via a virtual Lotus Notes-based TeamRoom. This new approach respecting multicultural differences, common views, and minority opinions, is available in http://www.teamspace.net/ CSF, presenting the implicit, complementary version of this explicit, printed consensus. Three key recommendations were made: CSF and (appropriately diluted) serum samples should be analyzed together in one analytical run, i.e., with reference to the same calibration curve. Results are evaluated as CSF/serum quotients, taking into account the non-linear, hyperbolic relation between immunoglobulin (Ig)- and albumin-quotients rather than using the linear IgG index or IgG synthesis rate. Controls should include materials with values within the reference ranges (IgM: 0.5-1.5 mg/l; IgA: 1-3 mg/l; IgG: 10-30 mg/l and albumin: 100-300 mg/l). The physiological, methodological and clinical significance of CSF/serum quotients is reviewed. We confirmed the previous consensus on oligoclonal IgG, in particular the usefulness of the five typical interpretation patterns. The group compared current external and internal quality assurance schemes and encouraged all members to maintain national or local traditions. Values for acceptable imprecision in the CSF quality assurance are proposed.

Original languageEnglish
Pages (from-to)331-337
Number of pages7
JournalClinical Chemistry and Laboratory Medicine
Volume41
Issue number3
DOIs
Publication statusPublished - 2003

Keywords

  • Albumin
  • Cerebrospinal fluid
  • Immunoglobulins
  • Oligoclonal IgG
  • Quality assurance
  • Total protein

ASJC Scopus subject areas

  • Clinical Biochemistry

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