β-trace protein test: new guidelines for the reliable diagnosis of cerebrospinal fluid fistula

Meço, Cem; Oberascher, G; Arrer, Erich; Moser, Gerhard; Albegger, Klaus

doi:10.1016/s0194-5998(03)01448-7

Cited by 74 publications

(20 citation statements)

References 20 publications

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“…115 Nevertheless, multiple disadvantages have been cited for this test, the most important being the highly intensive work and length of time required to perform the assays (1-2 days) and the need for high expertise in the interpretation of the results (Table 2). 85 Another protein proposed as a potential marker for the diagnosis of CSF rhinorrhea is b-trace protein, or bTP. 4,45,[83][84][85]98,103,112 It is the second most abundant protein in human CSF following albumin 83 and is mainly produced in the epithelial cells of the choroid plexus and in the leptomeninges in the CNS.…”

Section: Diagnosis Of Csf Rhinorrheamentioning

confidence: 99%

“…85 Another protein proposed as a potential marker for the diagnosis of CSF rhinorrhea is b-trace protein, or bTP. 4,45,[83][84][85]98,103,112 It is the second most abundant protein in human CSF following albumin 83 and is mainly produced in the epithelial cells of the choroid plexus and in the leptomeninges in the CNS. 83,103 The CSF concentration of bTP is approximately 35-fold higher than in plasma.…”

Section: Diagnosis Of Csf Rhinorrheamentioning

confidence: 99%

“…98 The overall accuracy of this method in diagnosing CSF leaks has been reported to approach 0.974, with a negative predictive value of 0.971 and a positive predictive value of 1. 8 The advantages of using bTP rather than b2-transferrin as a marker for CSF rhinorrhea have been described by Meco and colleagues 85 as less time consuming, less labor intensive (< 15 minutes), and less expensive. Furthermore, the bTP test carries all the advantages of the b2-transferrin test: noninvasive, repeatable, same sample collection methods, and high sensitivity and specificity.…”

Section: Diagnosis Of Csf Rhinorrheamentioning

confidence: 99%

“…The wide use of bTP for this purpose has been slow because the test is not suitable in patients with bacterial meningitis or those with reduced glomerular filtration because of variation in the levels of this protein. 85,113 Furthermore, at concentrations between 1.31 and 1.69 mg/L in the nasal secretions, there is an overlap of individuals with and without CSF leakage. 85,103 For these patients, other tests are required to confirm the pathological condition (Fig.…”

Section: Diagnosis Of Csf Rhinorrheamentioning

confidence: 99%

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Diagnosis and treatment of cerebrospinal fluid rhinorrhea following accidental traumatic anterior skull base fractures

Ziu¹,

Savage²,

Jimenez³

2012

FOC

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Cerebrospinal fluid rhinorrhea is a serious and potentially fatal condition because of an increased risk of meningitis and brain abscess. Approximately 80% of all cases occur in patients with head injuries and craniofacial fractures. Despite technical advances in the diagnosis and management of CSF rhinorrhea caused by craniofacial injury through the introduction of MRI and endoscopic extracranial surgical approaches, difficulties remain. The authors review here the pathophysiology, diagnosis, and management of CSF rhinorrhea relevant exclusively to traumatic anterior skull base injuries and attempt to identify areas in which further work is needed.

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Section: Diagnosis Of Csf Rhinorrheamentioning

confidence: 99%

Section: Diagnosis Of Csf Rhinorrheamentioning

confidence: 99%

Section: Diagnosis Of Csf Rhinorrheamentioning

confidence: 99%

Section: Diagnosis Of Csf Rhinorrheamentioning

confidence: 99%

See 2 more Smart Citations

Diagnosis and treatment of cerebrospinal fluid rhinorrhea following accidental traumatic anterior skull base fractures

Ziu¹,

Savage²,

Jimenez³

2012

FOC

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show abstract

“…Nevertheless, the test has the advantage of being quickly to perform, in about 15 minutes, being able to detect very low levels of CSF in the nasal secretion. Other advantages of the beta-trace protein are similar to the b2-transferrin test: non-invasive, repeatable, easy sample collection methods, elevated sensitivity [21][22][23][24] .…”

Section: Laboratory Testsmentioning

confidence: 99%

Current insights in CSF leaks: a literature review of mechanisms, pathophysiology and treatment options

Patrascu¹,

Manea²,

Sarafoleanu³

2017

Romanian Journal of Rhinology

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A cerebrospinal fluid (CSF) leak occurs when there appears a fistula between the dura and the skull base and it is usually characterized by discharge of cerebrospinal fluid from the nose. Cerebrospinal fluid leaks may have many etiologies, the most common being trauma. The most common site of dural lesion is the cribriform plate of the ethmoid. Diagnosis can be achieved by a multitude of techniques, high-resolution computed tomography being the modality of choice and it may be completed with magnetic resonance imaging or cisternography. Treatment may be either conservative, either surgical, related to the cause, the site and the duration of CSF leak. Conservative treatment usually includes strict bed rest, elevated bed head and no straining, nose blowing or stretching, with resolution of the majority of traumatic CSF leaks in seven days. Surgical treatment consists of a variety of approaches (intracranial/extracranial, open/endoscopic). The future trend is represented by minimally invasive endoscopic approaches, with a success rate of almost 90%; however, open transcranial or extracranial interventions still have indications in the surgical management. CSF leaks must be correctly diagnosed and treated, because the risk of intracranial complications increases 10-fold when the leakage persists.

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Diagnostic Relevance of β2-Transferrin for the Detection of Cerebrospinal Fluid Fistulas

Warnecke

Averbeck²,

Wurster³

et al. 2004

Arch Otolaryngol Head Neck Surg

117

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The ␤ 2-transferrin assay is a specific method to identify cerebrospinal fluid (CSF). Hitherto, this test has not been widely used for the routine screening of patients with suspected CSF leakage. The purpose of this study was to investigate the clinical relevance of the identification of ␤ 2-transferrin by comparing the test results with other diagnostic measures and intraoperative findings. Design: Case series. Patients: Retrospective analysis of 182 patients tested once or multiple times for ␤ 2-transferrin. Main Outcome Measures: Information was obtained regarding different diagnostic procedures applied to diagnose CSF leakage. The effectiveness of those diagnostic measures was compared. Results: The main indication to test for ␤ 2-transferrin was posttraumatic rhinorrhea (25%), followed by spontaneous (22%) and postsurgical (22%) rhinorrhea. In 35 of 205 cases, ␤ 2-transferrin was detected in the tested specimens. Thirteen of these required surgical intervention for treatment of the CSF fistula, and the leakage site was identified in all of them. Taking all results into consideration, the highest correlation was observed between the ␤ 2-transferrin assay, intrathecal fluorescein application, and surgical exploration. Conclusions: The ␤ 2-transferrin assay is a reliable method for confirming suspected CSF and should be used as a primary screening method in all patients with suspected CSF leakage. Although less invasive, the ␤ 2transferrin assay almost matches the high sensitivity achieved by exploratory surgery and intrathecal application of fluorescein. However, the possibility of bias should be carefully considered, and in particular, negative results should be critically compared with clinical symptoms and with results from other diagnostic procedures.

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β-trace protein test: new guidelines for the reliable diagnosis of cerebrospinal fluid fistula

Cited by 74 publications

References 20 publications

Diagnosis and treatment of cerebrospinal fluid rhinorrhea following accidental traumatic anterior skull base fractures

Diagnosis and treatment of cerebrospinal fluid rhinorrhea following accidental traumatic anterior skull base fractures

Current insights in CSF leaks: a literature review of mechanisms, pathophysiology and treatment options

Diagnostic Relevance of β2-Transferrin for the Detection of Cerebrospinal Fluid Fistulas

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