Cerebrospinal fluid ferritin—Unspecific and unsuitable for disease monitoring
Subarachnoid hemorrhage is sometimes difficult to diagnose radiologically. Cerebrospinal fluid (CSF) ferritin has been proposed to be highly specific and sensitive to detect hemorrhagic central nervous system (CNS) disease. We analyzed here the specificity of CSF ferritin in a large series of variou...
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Published in | Neurologia i neurochirurgia polska Vol. 48; no. 2; pp. 116 - 121 |
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Main Authors | , , , |
Format | Journal Article |
Language | English |
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Elsevier Urban & Partner Sp. z o.o
01.01.2014
Wydawnictwo Via Medica |
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Abstract | Subarachnoid hemorrhage is sometimes difficult to diagnose radiologically. Cerebrospinal fluid (CSF) ferritin has been proposed to be highly specific and sensitive to detect hemorrhagic central nervous system (CNS) disease. We analyzed here the specificity of CSF ferritin in a large series of various CNS diseases and the influence of serum ferritin.
CSF ferritin, lactate, protein and total cell count were analyzed in 141 samples: neoplastic meningitis (n=62), subarachnoid hemorrhage (n=20), pyogenic infection (n=10), viral infection (n=10), multiple sclerosis (n=10), borreliosis (n=5) and normal controls (n=24). Cerebrospinal fluid ferritin was measured with a microparticle immunoassay. In addition, serum and CSF ferritin were compared in 18 samples of bacterial and neoplastic meningitis.
In CNS hemorrhage, median ferritin was 51.55μg/L (sensitivity: 90%) after the second lumbar puncture. In neoplastic meningitis, the median CSF ferritin was 16.3μg/L (sensitivity: 45%). Interestingly, ferritin was higher in solid tumors than that in hematological neoplasms. In 90% of pyogenic inflammation, ferritin was elevated with a median of 53.35μg/L, while only 50% of patients with viral infection had elevated CSF ferritin. In ventricular CSF, median ferritin was 163μg/L, but only 20.6μg/L in lumbar CSF. Ferritin was normal in multiple sclerosis and borreliosis.
Ferritin was elevated not only in hemorrhagic disease, but also in neoplastic and infectious meningitis. Ferritin was not a reliable marker of the course of disease. The influence of serum ferritin on CSF ferritin is negligible. We conclude that elevated CSF ferritin reliably, but unspecifically indicates severe CNS disease. |
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AbstractList | Subarachnoid hemorrhage is sometimes difficult to diagnose radiologically. Cerebrospinal fluid (CSF) ferritin has been proposed to be highly specific and sensitive to detect hemorrhagic central nervous system (CNS) disease. We analyzed here the specificity of CSF ferritin in a large series of various CNS diseases and the influence of serum ferritin.
CSF ferritin, lactate, protein and total cell count were analyzed in 141 samples: neoplastic meningitis (n=62), subarachnoid hemorrhage (n=20), pyogenic infection (n=10), viral infection (n=10), multiple sclerosis (n=10), borreliosis (n=5) and normal controls (n=24). Cerebrospinal fluid ferritin was measured with a microparticle immunoassay. In addition, serum and CSF ferritin were compared in 18 samples of bacterial and neoplastic meningitis.
In CNS hemorrhage, median ferritin was 51.55μg/L (sensitivity: 90%) after the second lumbar puncture. In neoplastic meningitis, the median CSF ferritin was 16.3μg/L (sensitivity: 45%). Interestingly, ferritin was higher in solid tumors than that in hematological neoplasms. In 90% of pyogenic inflammation, ferritin was elevated with a median of 53.35μg/L, while only 50% of patients with viral infection had elevated CSF ferritin. In ventricular CSF, median ferritin was 163μg/L, but only 20.6μg/L in lumbar CSF. Ferritin was normal in multiple sclerosis and borreliosis.
Ferritin was elevated not only in hemorrhagic disease, but also in neoplastic and infectious meningitis. Ferritin was not a reliable marker of the course of disease. The influence of serum ferritin on CSF ferritin is negligible. We conclude that elevated CSF ferritin reliably, but unspecifically indicates severe CNS disease. BACKGROUND AND PURPOSE: Subarachnoid hemorrhage is sometimes difficult to diagnose radiologically. Cerebrospinal fluid (CSF) ferritin has been proposed to be highly specific and sensitive to detect hemorrhagic central nervous system (CNS) disease. We analyzed here the specificity of CSF ferritin in a large series of various CNS diseases and the influence of serum ferritin. MATERIALS AND METHODS: CSF ferritin, lactate, protein and total cell count were analyzed in 141 samples: neoplastic meningitis (n=62), subarachnoid hemorrhage (n=20), pyogenic infection (n=10), viral infection (n=10), multiple sclerosis (n=10), borreliosis (n=5) and normal controls (n=24). Cerebrospinal fluid ferritin was measured with a microparticle immunoassay. In addition, serum and CSF ferritin were compared in 18 samples of bacterial and neoplastic meningitis. RESULTS: In CNS hemorrhage, median ferritin was 51.55μg/L (sensitivity: 90%) after the second lumbar puncture. In neoplastic meningitis, the median CSF ferritin was 16.3μg/L (sensitivity: 45%). Interestingly, ferritin was higher in solid tumors than that in hematological neoplasms. In 90% of pyogenic inflammation, ferritin was elevated with a median of 53.35μg/L, while only 50% of patients with viral infection had elevated CSF ferritin. In ventricular CSF, median ferritin was 163μg/L, but only 20.6μg/L in lumbar CSF. Ferritin was normal in multiple sclerosis and borreliosis. CONCLUSIONS: Ferritin was elevated not only in hemorrhagic disease, but also in neoplastic and infectious meningitis. Ferritin was not a reliable marker of the course of disease. The influence of serum ferritin on CSF ferritin is negligible. We conclude that elevated CSF ferritin reliably, but unspecifically indicates severe CNS disease. BACKGROUND AND PURPOSESubarachnoid hemorrhage is sometimes difficult to diagnose radiologically. Cerebrospinal fluid (CSF) ferritin has been proposed to be highly specific and sensitive to detect hemorrhagic central nervous system (CNS) disease. We analyzed here the specificity of CSF ferritin in a large series of various CNS diseases and the influence of serum ferritin.MATERIALS AND METHODSCSF ferritin, lactate, protein and total cell count were analyzed in 141 samples: neoplastic meningitis (n=62), subarachnoid hemorrhage (n=20), pyogenic infection (n=10), viral infection (n=10), multiple sclerosis (n=10), borreliosis (n=5) and normal controls (n=24). Cerebrospinal fluid ferritin was measured with a microparticle immunoassay. In addition, serum and CSF ferritin were compared in 18 samples of bacterial and neoplastic meningitis.RESULTSIn CNS hemorrhage, median ferritin was 51.55μg/L (sensitivity: 90%) after the second lumbar puncture. In neoplastic meningitis, the median CSF ferritin was 16.3μg/L (sensitivity: 45%). Interestingly, ferritin was higher in solid tumors than that in hematological neoplasms. In 90% of pyogenic inflammation, ferritin was elevated with a median of 53.35μg/L, while only 50% of patients with viral infection had elevated CSF ferritin. In ventricular CSF, median ferritin was 163μg/L, but only 20.6μg/L in lumbar CSF. Ferritin was normal in multiple sclerosis and borreliosis.CONCLUSIONSFerritin was elevated not only in hemorrhagic disease, but also in neoplastic and infectious meningitis. Ferritin was not a reliable marker of the course of disease. The influence of serum ferritin on CSF ferritin is negligible. We conclude that elevated CSF ferritin reliably, but unspecifically indicates severe CNS disease. |
Author | Quint, Karl Proemmel, Peter Strik, Herwig M. Kolodziej, Malgorzata A. |
Author_xml | – sequence: 1 givenname: Malgorzata A. surname: Kolodziej fullname: Kolodziej, Malgorzata A. email: malgorzata.kolodziej@neuro.med.uni-giessen.de organization: Department of Neurosurgery, University of Giessen, Giessen, Germany – sequence: 2 givenname: Peter surname: Proemmel fullname: Proemmel, Peter organization: Department of Neurology, University of Goettingen, Goettingen, Germany – sequence: 3 givenname: Karl surname: Quint fullname: Quint, Karl organization: Institute of Surgical Research, University of Marburg, Marburg, Germany – sequence: 4 givenname: Herwig M. surname: Strik fullname: Strik, Herwig M. organization: Department of Neurology, University of Marburg, Marburg, Germany |
BackLink | https://www.ncbi.nlm.nih.gov/pubmed/24821637$$D View this record in MEDLINE/PubMed |
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CitedBy_id | crossref_primary_10_1080_21678421_2018_1555599 crossref_primary_10_1111_ene_15591 crossref_primary_10_1186_s12987_017_0057_2 crossref_primary_10_1186_s42466_020_0051_z crossref_primary_10_3109_1354750X_2016_1148777 crossref_primary_10_1111_jnc_15175 crossref_primary_10_1007_s15015_015_1540_8 crossref_primary_10_1186_s12917_019_1878_9 |
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Keywords | Meningitis Cerebrospinal fluid Subarachnoid hemorrhage Neoplastic meningitis Ferritin |
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Snippet | Subarachnoid hemorrhage is sometimes difficult to diagnose radiologically. Cerebrospinal fluid (CSF) ferritin has been proposed to be highly specific and... BACKGROUND AND PURPOSE: Subarachnoid hemorrhage is sometimes difficult to diagnose radiologically. Cerebrospinal fluid (CSF) ferritin has been proposed to be... BACKGROUND AND PURPOSESubarachnoid hemorrhage is sometimes difficult to diagnose radiologically. Cerebrospinal fluid (CSF) ferritin has been proposed to be... |
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SubjectTerms | Biomarkers - cerebrospinal fluid Borrelia Infections - cerebrospinal fluid Cerebrospinal fluid Disease Ferritin Ferritins - blood Ferritins - cerebrospinal fluid Hemorrhage Humans Infections Meningeal Carcinomatosis - blood Meningeal Carcinomatosis - cerebrospinal fluid Meningitis Meningitis, Bacterial - blood Meningitis, Bacterial - cerebrospinal fluid Meningitis, Viral - cerebrospinal fluid Multiple sclerosis Multiple Sclerosis - cerebrospinal fluid Neoplastic meningitis Prospective Studies Reproducibility of Results Retrospective Studies Severity of Illness Index Subarachnoid hemorrhage Subarachnoid Hemorrhage - blood Subarachnoid Hemorrhage - cerebrospinal fluid Viral infections |
Title | Cerebrospinal fluid ferritin—Unspecific and unsuitable for disease monitoring |
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