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proteins in other body fluids 30/5/2015Protein in other body fluidsUrinary proteins:proteinuriaPlasma Protein from blood & kidneyextraneous sources : prostate , vigina Quantitative measurement performed from timed urine (24hr urine protein)The volume should accurately measuredProtein in other body fluids

CSF proteins15 to 45 mg/dlIncreased CSF proteins:increased permeability of the capillary endothelial barrier bacterial, viral, and fungal meningitis; traumatic tap; multiple sclerosis; obstruction; neoplasmCSF protein is compared with serum albumin CSF albumin: plasma albumin is less than2.7:7.3Ratio more this indicates increase pearmeabilityCSF protein Decreased CSF proteins:Leak of CSF from a tear in the dura due to severe traumaOtorrohea: leak of CSF from earRhinorrohea: leak of CSF from nose

CSF protein Increased CSF proteins:Lysis of contaminant blood from traumatic tapIncreased permeability of epithelial membrane (blood-brain barrier)CNS bacterial or fungal infectionsCerebral hemorrhagesIncreased production by CNS tissue as in cases of:Multiple sclerosis (MS) Subacute sclerosing panencephalitis (SSPE)Obstruction as in cases of :Tumors or abscess

CSF protein Analysis of protein fractions: (Albumin & IgG)

1- Albumin of CSF is obtained from blood by means of blood-brain barrier (as it is produced solely by the liver) In cases of increased permeability of BBB, albumin is increased in CSF

2- IgG of CSF can be obtained: from blood (By BBB) : increase in cases of increase permeab. of BBB & by local synthesis from plasma cells within CSF (increased in cases of MS)

1. CHECK INTEGRITY OF BLOOD BRAIN BARRIER (BBB) BY CSF / serum albumin index calculation CSF serum albumin index = CSF albumin (mg/dl) / serum albumin (g/dl) Index less than 9 indicates intact BBB (no increased permeability of BBB)

How to determine the source of CSF IgG 2. CSF IgG INDEX IS CALCULATED CSF IgG / Serum IgG CSF IgG index = --------------------------------------- CSF albumin / serumalbumin Normal : less than 0.7 Increased in cases of demylineating diseases of CNS as : Multiple sclerosis (MS)

How to determine the source of CSF IgG CSF ImmunoglobulinCSF IgG can arise:from plasma cells within CSF& from the blood through BBBCSF [IgG] without concomitant in CSF [Alb] suggests local production of IgG:multiple sclerosis (MS)subacute sclerosing panencephalitis (SPEE) CSF IgG/Serum IgGCSF serum /Albumin indexCSF IgG index:Normally: < 0.7=CSF Electrophoresis: Oligoclonal Banding

Electrophoresis patterns of CSF fro patients who have multiple sclerosis have multiple distinct oligoclonal bands in the zone

Electrophoresis patterns of CSF fro patients who have multiple sclerosis have multiple distinct oligoclonal bands in the zone

Protein in other body fluidsAmniotic fluid : usually for AFP analysisPeritoneal & Pleural cavities:Transudates: total protein less than 3g/dlExudates: total protein more than 3g/dlThe ratio of pleural fluid protein to serum protein is greater than 0.5