What is Glucose Protein- Cerebrospinal fluid?

CSF protein

• The spinal fluid normally contains very little protein since serum proteins are large molecules that do not cross the blood-brain barrier. Most of the protein that is normally present is albumin.
• CSF protein concentration may rise due to 2 factors: either an increased permeability of the blood-brain barrier allowing more protein and higher molecular weight proteins to enter the CSF or proteins may be synthesised within the cerebrospinal canal by inflammatory or other invading cells.
• Mild protein elevation may be caused by viral meningitis, neurosyphilis, subdural haematoma, cerebral thrombosis, brain tumour, multiple sclerosis (rarely >1.00 g/L)
• Moderate or pronounced elevation may be caused by acute bacterial meningitis, tuberculous meningitis, spinal cord tumour, cerebral haemorrhage, Guillain-Barre syndrome.
• When CSF protein levels are low it can indicate rapid CSF production.

CSF glucose

• Glucose levels in CSF normally reflect the levels seen in the blood. There may be a 2–4 hour lag in the CSF level when compared to the blood level.
• Whilst not diagnostic, low glucose levels, as compared to plasma levels, are seen in bacterial meningitis, cryptococcal meningitis, malignant involvement of the meninges and sarcoidosis.
• Glucose levels are usually normal in viral infections of the CNS.

Sample requirements

• 1mL of CSF is approximately equal to 25 drops from the Luer connector of the needle.
• Results on bloodstained samples will be unreliable.
• Samples from CGH are sent directly to GRH Pathology from the ward or from CGH Pathology if delivered there.

Protein

• Preferred tap: Tap #2 or #4
• CSF volume: Minimum 0.25 mL (6 drops)
• Sample tube: Plain Universal container (tubes containing gel or anticoagulant are not suitable for analysis of CSF protein).