CSF Protein

1. See Also
   1. Cerebrospinal Fluid
   2. Cerebrospinal Fluid Examination
   3. Lumbar Puncture
2. Interpretation
   1. Normal
      1. Newborn: <150 mg/dl
      2. Adult: 18 to 58 mg/dl
   2. CSF Protein is not related to Serum Protein levels
      1. Low Serum Protein does not cause low CSF Protein
3. Correction of Protein for CSF RBC
   1. Protein rises 1 mg/dl for every 1000 CSF RBCs
   2. Same tube must be used for protein and CSF RBC Count
4. Increased CSF Protein
   1. Diabetes Mellitus
   2. Brain Tumor
      1. Meningioma
      2. Acoustic Neuroma
      3. Ependymoma
   3. Encapsulated brain abscess
   4. Spinal cord tumor
   5. Multiple Sclerosis
   6. Acute purulent Meningitis
   7. Granulomatous Meningitis
   8. Carcinomatous Meningitis
   9. Syphilis (protein may be normal if longstanding)
   10. Guillain-Barre Syndrome (Infectious polyneuritis)
       1. Protein normal during first few days
       2. Rises after first week
   11. Cushing's Disease
   12. Connective tissue disease
   13. Uremia
   14. Myxedema
   15. Cerebral hemorrhage
5. Normal CSF Protein
   1. Brainstem Glioma
   2. Viral CNS Infections
   3. Multiple Sclerosis (protein may be mildly elevated)
   4. Ischemic Cerebrovascular Accident
6. Decreased CSF Protein
   1. Recent Lumbar Puncture
   2. Chronic CSF leakage
   3. May be normal if age <2 years
   4. Acute water intoxication
7. References
   1. Kooiker in Roberts (1998) Procedures in ER, p. 1067-75
   2. Ravel (1995) Lab Medicine, Mosby, p. 294-9
   3. Tunkel in Mandell (2000) Infectious Disease, p. 974-8
   4. Seehusen (2003) Am Fam Physician 68:1103-8