Kahlmann V, Roodbol J, van Leeuwen N, Ramakers C R B, van Pelt D, Neuteboom R F, Catsman-Berrevoets C E, de Wit M C Y, Jacobs B C
Department of Neurology, Erasmus MC - Sophia Children's Hospital, University Medical Center Rotterdam, The Netherlands; Department of Paediatric Neurology, Erasmus MC - Sophia Children's Hospital, University Medical Center Rotterdam, The Netherlands.
Department of Public Health, Erasmus MC - Sophia Children's Hospital, University Medical Center Rotterdam, The Netherlands.
Eur J Paediatr Neurol. 2017 Jul;21(4):654-660. doi: 10.1016/j.ejpn.2017.03.006. Epub 2017 Apr 8.
To define age-specific reference values for cerebrospinal fluid (CSF) total protein levels for children and validate these values in children with Guillain-Barré syndrome (GBS), acute disseminated encephalomyelitis (ADEM) and multiple sclerosis (MS).
Reference values for CSF total protein levels were determined in an extensive cohort of diagnostic samples from children (<18 year) evaluated at Erasmus Medical Center/Sophia Children's Hospital. These reference values were confirmed in children diagnosed with disorders unrelated to raised CSF total protein level and validated in children with GBS, ADEM and MS.
The test results of 6145 diagnostic CSF samples from 3623 children were used to define reference values. The reference values based on the upper limit of the 95% CI (i.e. upper limit of normal) were for 6 months-2 years 0.25 g/L, 2-6 years 0.25 g/L, 6-12 years 0.28 g/L, 12-18 years 0.34 g/L. These reference values were confirmed in a subgroup of 378 children diagnosed with disorders that are not typically associated with increased CSF total protein. In addition, the CSF total protein levels in these children in the first 6 months after birth were highly variable (median 0.47 g/L, IQR 0.26-0.65). According to these new reference values, CSF total protein level was elevated in 85% of children with GBS, 66% with ADEM and 23% with MS.
More accurate age-specific reference values for CSF total protein levels in children were determined. These new reference values are more sensitive than currently used values for diagnosing GBS and ADEM in children.
确定儿童脑脊液（CSF）总蛋白水平的年龄特异性参考值，并在吉兰-巴雷综合征（GBS）、急性播散性脑脊髓炎（ADEM）和多发性硬化症（MS）患儿中验证这些值。
在伊拉斯姆斯医学中心/索菲亚儿童医院评估的大量18岁以下儿童诊断样本队列中确定CSF总蛋白水平的参考值。这些参考值在诊断为与CSF总蛋白水平升高无关的疾病的儿童中得到确认，并在GBS、ADEM和MS患儿中进行验证。
来自3623名儿童的6145份诊断性CSF样本的检测结果用于定义参考值。基于95%置信区间上限（即正常上限）的参考值为6个月至2岁0.25g/L，2至6岁0.25g/L，6至12岁0.28g/L，12至18岁0.34g/L。这些参考值在378名诊断为通常与CSF总蛋白增加无关的疾病的儿童亚组中得到确认。此外，这些儿童出生后头6个月的CSF总蛋白水平高度可变（中位数0.47g/L，四分位间距0.26 - 0.65）。根据这些新的参考值，85%的GBS患儿、66%的ADEM患儿和23%的MS患儿CSF总蛋白水平升高。
确定了更准确的儿童CSF总蛋白水平的年龄特异性参考值。这些新的参考值在诊断儿童GBS和ADEM时比目前使用的值更敏感。
