National audit of cerebrospinal fluid testing

Ann Clin Biochem 2007;44:443-448
© 2007 Association for Clinical Biochemistry


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Original Articles

Ian Holbrook,
Robert Beetham,
Anne Cruickshank,
William Egner,
Mike Fahie-Wilson,
Geoff Keir,
Dina Patel,
Ian Watson and
Peter White

Department of Clinical Biochemistry, York Hospital, York YO31 8HE, UK;
Department of Clinical Biochemistry, Frenchay Hospital, Bristol BS16 1LE, UK;
Biochemistry Department, Southern General Hospital, Glasgow G51 4TF, UK;
Department of Immunology, Northern General Hospital, Sheffield S5 7YT, UK;
Biochemistry Department, Southend Hospital, Westcliff on Sea SS0 0RY, UK;
Department of Neuroimmunology, National Hospital for Neurology and Neurosurgery, London WC1N 3BG, UK;
Department of Immunology, Northern General Hospital, Sheffield S5 7YT, UK;
Department of Clinical Biochemistry, University Hospital Aintree, Liverpool L9 7AL, UK;
Department of Immunology, Northern General Hospital, Sheffield S5 7YT, UK

Background: UK National External Quality Assessment Service(NEQAS) Specialist Advisory Group for EQA of CSF Proteins andBiochemistry was interested in current practice for the biochemicalinvestigation of cerebrospinal fluid (CSF) in the UK.

Methods: A questionnaire was sent to laboratories via regionalaudit committees and the results collated.

Results: Most laboratories were analysing CSF in a satisfactorymanner. There was some variation in the reference ranges usedfor glucose, protein and lactate. There was concern about therejection policies of some laboratories on these unrepeatablesamples and the wavelengths used to measure bilirubin. The surveyrevealed the lack of spectrophotometric scanning for haem pigmentsand bilirubin in some hospitals.

Conclusions: The current practice for the measurement of CSFsamples in the UK is satisfactory in most laboratories respondingto the questionnaire. National agreement on reference rangesfor glucose, protein and lactate should be achievable. Thoseperforming spectrophotometric scanning of the CSF were doingso in concordance with the national guidelines. Some hospitalsin the UK may not have responded to the questionnaire becausethey did not offer spectrophotometric scanning.

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