Age-specific reference values for cerebrospinal fluid protein concentration in neonates and young infants.
Summary of "Age-specific reference values for cerebrospinal fluid protein concentration in neonates and young infants."
: Cerebrospinal fluid (CSF) protein values decline over the first few months of life as the infant's blood-CSF barrier matures. However, published studies differ in the reported rate, timing, and magnitude of this decline.
: To quantify the age-related changes in CSF protein concentration and to determine accurate, age-specific reference values for neonates and young infants. DESIGN, SETTING AND
: This cross-sectional study included infants age 56 days or younger who had a lumbar puncture performed in the emergency department of an urban tertiary care children's hospital between January 1, 2005 and June 30, 2007. Infants with conditions associated with elevated CSF protein concentrations, including traumatic lumbar puncture and bacterial or viral meningitis, were excluded.
: Of 1064 infants undergoing lumbar puncture, 375 (35%) met inclusion criteria. The median CSF protein value was 58 mg/dL (interquartile range: 48-72 mg/dL). In linear regression, the CSF protein concentration decreased 6.8% (95% confidence interval [CI], 5.4%-8.1%; P < 0.001) with each 1 week increase in age. The 95th percentile values were 115 mg/dL for infants =28 days and 89 mg/dL for infants 29-56 days. The 95th percentile values by age category were as follows: ages 0-14 days, 132 mg/dL; ages 15-28 days, 100 mg/dL; ages 29-42 days, 89 mg/dL; and ages 43-56 days, 83 mg/dL.
: We quantify the age-related decline in CSF protein concentration among infants 56 days of age and younger and provide age-specific reference values. The values reported here represent the largest series to-date for this age group. Journal of Hospital Medicine 2010. (c) 2010 Society of Hospital Medicine.
Division of Infectious Diseases, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
This article was published in the following journal.
Name: Journal of hospital medicine : an official publication of the Society of Hospital Medicine
Medical and Biotech [MESH] Definitions
Cerebrospinal Fluid Proteins
Proteins in the cerebrospinal fluid, normally albumin and globulin present in the ratio of 8 to 1. Increases in protein levels are of diagnostic value in neurological diseases. (Brain and Bannister's Clinical Neurology, 7th ed, p221)
Cerebrospinal Fluid Shunts
Tubes inserted to create communication between a cerebral ventricle and the internal jugular vein. Their emplacement permits draining of cerebrospinal fluid for relief of hydrocephalus or other condition leading to fluid accumulation in the ventricles.
Cerebrospinal Fluid Rhinorrhea
Discharge of cerebrospinal fluid through the nose. Common etiologies include trauma, neoplasms, and prior surgery, although the condition may occur spontaneously. (Otolaryngol Head Neck Surg 1997 Apr;116(4):442-9)
Cerebrospinal Fluid Pressure
Manometric pressure of the CEREBROSPINAL FLUID as measured by lumbar, cerebroventricular, or cisternal puncture. Within the cranial cavity it is called INTRACRANIAL PRESSURE.
Cerebrospinal Fluid Otorrhea
Discharge of cerebrospinal fluid through the external auditory meatus or through the eustachian tube into the nasopharynx. This is usually associated with CRANIOCEREBRAL TRAUMA (e.g., SKULL FRACTURE involving the TEMPORAL BONE;), NEUROSURGICAL PROCEDURES; or other conditions, but may rarely occur spontaneously. (From Am J Otol 1995 Nov;16(6):765-71)
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