Automated cerebrospinal fluid cell count — New reference ranges and evaluation of its clinical use in central nervous system infections

Bremell, Daniel; Mattsson, Niklas; Wallin, Fredrik; Henriksson, John; Wall, Mariann; Blennow, Kaj; Zetterberg, Henrik; Hagberg, Lars

doi:10.1016/j.clinbiochem.2013.11.010

Cited by 23 publications

(16 citation statements)

References 14 publications

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“…The adult patients included in our study had no history of neurological diseases; whereas, Sandhaus et al [56] included samples from both children and adults with known CNS disorders. More recently, new reference ranges for CSF samples (n = 80) of neurologically healthy patients undergoing orthopedic surgery were measured on the Advia 2120i, and were reported to be < 7 × 10 6 /L [57], which are in concordance with our study [55].…”

Section: Cerebrospinal Fluid (Csf)supporting

confidence: 77%

“…The current reference ranges referenced by manufacturers and textbooks were established decades ago using manual microscopy. However, with many laboratories transitioning from manual to automated methods, old reference ranges should be verified because higher reference ranges have been reported using automated methods [55][56][57].…”

Section: Cerebrospinal Fluid (Csf)mentioning

confidence: 99%

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Clinical relevance and contemporary methods for counting blood cells in body fluids suspected of inflammatory disease

Fleming

Russcher

Lindemans

et al. 2015

Clinical Chemistry and Laboratory Medicine (CCLM)

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Abstract:In many inflammatory diseases, the cellular components in body fluids [cerebrospinal fluid (CSF), serous fluids] are increased, rendering essential diagnostic information. The diagnostic value of the total white blood cell count (WBC) and differential count has been evaluated extensively over the years, and a remarkable amount of knowledge has been gained; yet, there is a great deal of clinical uncertainty whether the diagnosis should be based solely on these variables. In some diseases, such as peritonitis, the total WBC and differential count has high sensitivity; whereas, in differentiating pleural effusions, it lacks the sensitivity required to be clinically useful. Nevertheless, many guidelines consider these tests as cornerstone parameters, and in combination with clinical variables, they can successfully guide clinical decision making in initiating or postponing a treatment course for infection and/or inflammatory diseases while awaiting culture results. Although other methods are available for detecting and differentiating WBCs in body fluids, manual microscopy is still considered the gold standard despite its many limitations. During the last decade, automated analyzers have become a popular method for first line screening. Continued progress in their design has led to major improvements including their speed, improved accuracy and lower variability compared with microscopy. Disadvantages of this method include high imprecision in low ranges (depending on the method) and interfering factors.In a time where automation is at the front line in clinical laboratories, it is essential the results obtained are precise, accurate and reproducible. This review provides an overview of the relevance for cell counting in a variety of diagnostic body fluids, and highlights the current technologies used.

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Section: Cerebrospinal Fluid (Csf)supporting

confidence: 77%

Section: Cerebrospinal Fluid (Csf)mentioning

confidence: 99%

Clinical relevance and contemporary methods for counting blood cells in body fluids suspected of inflammatory disease

Fleming

Russcher

Lindemans

et al. 2015

Clinical Chemistry and Laboratory Medicine (CCLM)

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“…Some data in literature have highlighted the problem of the range normal cellularity in CSF with the automation count. Definition of instrumental optimal specific cut-off was useful in this respect too [36,37].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Mindray BC-6800 body fluid mode for automated cerebrospinal fluid cell counting

Buoro

Seghezzi

Mecca

et al. 2016

Clinical Chemistry and Laboratory Medicine (CCLM)

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“…Routine clinical analysis data of albumin levels and number of mono- and polynuclear cells in CSF were retrieved from medical records of HSE and HSM patients. Reference values for healthy individuals are for albumin <320 mg/L (15–45 years) and <420 mg/L (>45 years), for mononuclear cells <5 × 10 6 cells/L and for polynuclear cells <3 × 10 6 cells/L [29]. …”

Section: Methodsmentioning

confidence: 99%

CXCL11 production in cerebrospinal fluid distinguishes herpes simplex meningitis from herpes simplex encephalitis

Lind¹,

Studahl²,

Berg³

et al. 2017

J Neuroinflammation

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BackgroundThe closely related herpes simplex viruses 1 and 2 can cause inflammations of the central nervous system (CNS), where type 1 most often manifest as encephalitis (HSE), and type 2 as meningitis (HSM). HSE is associated with severe neurological complications, while HSM is benign in adults. We proposed that studying the chemokine and cytokine production in cerebrospinal fluid (CSF) and serum could indicate why two closely related viruses exhibit different severity of their accompanied CNS inflammation.MethodsSecretion patterns of 30 chemokines and 10 cytokines in CSF of adult patients with acute HSE (n = 14) and HSM (n = 20) in the initial stage of disease were analyzed and compared to control subjects without viral central nervous system infections and to levels in serum.ResultsMost measured chemokines and cytokines increased in CSF of HSE and HSM patients. Overall, the CSF chemokine levels were higher in CSF of HSM patients compared to HSE patients. However, only five chemokines reached levels in the CSF that exceeded those in serum facilitating a positive CSF-serum chemokine gradient. Of these, CXCL8, CXCL9, and CXCL10 were present at high levels both in HSE and HSM whereas CXCL11 and CCL8 were present in HSM alone. Several chemokines were also elevated in serum of HSE patients but only one in HSM patients. No chemokine in- or efflux between CSF and serum was indicated as the levels of chemokines in CSF and serum did not correlate.ConclusionsWe show that HSM is associated with a stronger and more diverse inflammatory response in the CNS compared to HSE in the initial stage of disease. The chemokine patterns were distinguished by the exclusive local CNS production of CXCL11 and CCL8 in HSM. Inflammation in HSM appears to be restricted to the CNS whereas HSE also was associated with systemic inflammation.Electronic supplementary materialThe online version of this article (doi:10.1186/s12974-017-0907-5) contains supplementary material, which is available to authorized users.

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Automated cerebrospinal fluid cell count — New reference ranges and evaluation of its clinical use in central nervous system infections

Cited by 23 publications

References 14 publications

Clinical relevance and contemporary methods for counting blood cells in body fluids suspected of inflammatory disease

Clinical relevance and contemporary methods for counting blood cells in body fluids suspected of inflammatory disease

Evaluation of Mindray BC-6800 body fluid mode for automated cerebrospinal fluid cell counting

CXCL11 production in cerebrospinal fluid distinguishes herpes simplex meningitis from herpes simplex encephalitis

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