How accurate is the beta-2-transferrin test?
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Beta-2-transferrin is a protein found only in CSF and perilymph. With sensitivity of 94% – 100%, and specificity of 98% – 100%5, this assay has become the gold standard in detection of CSF leakage.
What does beta-2-transferrin do?
Beta-2-transferrin is a protein produced by neuraminidase activity in the brain which is uniquely found in the cerebrospinal fluid (CSF) and perilymph. Its absence in other body secretions makes its detection invaluable in diagnosing a CSF leak.
How do you know if you have a CSF leak in your nose?
Diagnosing a CSF leak includes an analysis of the nasal fluid for a protein called beta-2 transferrin which is most only found in cerebrospinal fluid. CT and MRI scans may also be require to determine the location and severity of the leakage.
Can CSF leak symptoms come and go?
Frank P.K. Hsu, chair of the department of neurological surgery at UC Irvine Health, said that the fluid may also “come and go.” When fluid accumulates in a space inside the head, it can come rushing out when you tip your head forward — “like a bucket being filled up and then dumped.”
How do you know if you have CSF after a head injury?
Patients may experience a salty taste or may have ear fullness or hearing loss. There may also be a ‘Reservoir sign’ in which the CSF goes out when taking a head up position in the lying position. Most patients of the CSF leakage complained of headache.
How is CSF rhinorrhea diagnosed?
The injection of intrathecal fluorescein has been used to diagnose and localize the site(s) of cerebrospinal fluid (CSF) rhinorrhea. The injection of intrathecal fluorescein is commonly used to diagnose and localize the site(s) of CSF rhinorrhea.
How can you tell the difference between nasal discharge and CSF?
Handker chief test: When the discharge from the nose is buried in a handkerchief or dry gauze, the CSF is more likely to be clear if it is not sticky The Handker chief test is a test to determine the nasal discharge, which is unclear and sticky due to mucin secretion from the nose.
Can a CSF leak cause permanent damage?
CSF leaks occur when there is a breakdown in this barrier. The dura can be damaged by certain surgeries, head trauma, and tumors. Leaks sometimes occur spontaneously. Untreated CSF leaks can lead to life-threatening meningitis, brain infections, or stroke.
How do you test for beta-2 transferrin?
In the clinical immunology laboratory, nasal and ear fluids are tested for detection of the beta-2 transferrin band by immunofixation electrophoresis (IFE) or Western blot analysis as a diagnostic tool for the presence of CSF or perilymph.
How is beta-2 transferrin detected?
Detection of a beta-2 transferrin band by IFE is diagnostic for the presence of cerebrospinal fluid (CSF). This test is useful in the differential diagnosis for CSF otorrhea or CSF rhinorrhea. Beta-2 transferrin is not detected by this methodology in normal serum, tears, saliva, sputum, nasal, or aural fluid.
What can mimic a CSF leak?
POTS, orthostatic hypotension, cervicogenic headache, vestibular migraine, and prior Chiari decompression surgery are all causes of orthostatic headache that may mimic spinal CSF leak and must be distinguished for patients to receive appropriately directed therapy.