Journal article

Publication year: 2014

Pages: 116-121

Journal: Neurologia i Neurochirurgia Polska

Volume number: 48

Issue number: 2

ISSN: 0028-3843

eISSN: 1897-4260

Open access status: Green

DOI Link: https://doi.org/10.1016/j.pjnns.2013.09.004

Publisher: Efekt

Abstract: 

Background and purpose: Subarachnoid hemorrhage is sometimes difficult to diagnose radio-logically. 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 51.55 mu g/L (sensitivity: 90%) after the second lumbar puncture. In neoplastic meningitis, the median CSF ferritin was 16.3 mu g/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 53.35 mu g/L, while only 50% of patients with viral infection had elevated CSF ferritin. In ventricular CSF, median ferritin was 163 mu g/L, but only 20.6 mu g/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. (C) 2014 Polish Neurological Society. Published by Elsevier Urban & Partner Sp. z o.o. All rights reserved.

Harvard Citation style: Kolodziej, M., Proemmel, P., Quint, K. and Strik, H. (2014) Cerebrospinal fluid ferritin - Unspecific and unsuitable for disease monitoring, Neurologia i Neurochirurgia Polska, 48(2), pp. 116-121. https://doi.org/10.1016/j.pjnns.2013.09.004

APA Citation style: Kolodziej, M., Proemmel, P., Quint, K., & Strik, H. (2014). Cerebrospinal fluid ferritin - Unspecific and unsuitable for disease monitoring. Neurologia i Neurochirurgia Polska. 48(2), 116-121. https://doi.org/10.1016/j.pjnns.2013.09.004