Albumin Level / Cerebrospinal Fluid (CSF) Test
Test Description
The Albumin Level / CSF Test measures the concentration of albumin in cerebrospinal fluid (CSF), providing essential insights into the integrity of the blood-brain barrier (BBB). Albumin is a major protein synthesized in the liver and is typically present in low concentrations within the CSF, as it does not originate from within the central nervous system. Elevated levels of albumin in CSF may indicate a compromised BBB, which can occur in various neurological and inflammatory conditions.
Clinical Significance
The blood-brain barrier is a highly selective membrane that protects the brain by preventing harmful substances in the bloodstream from entering the central nervous system. When the BBB is disrupted, proteins like albumin can leak into the CSF, serving as a biomarker for barrier dysfunction.
This test is important in evaluating:
- Neurological disorders involving inflammation or infection
- Neurodegenerative diseases affecting BBB integrity
- Disease progression and prognosis in conditions like ALS or multiple sclerosis
Indications for the Albumin CSF Test
This test may be recommended to:
- Assess Blood-Brain Barrier Dysfunction: Elevated CSF albumin suggests compromised BBB integrity, which may be seen in multiple sclerosis (MS), Guillain-Barré syndrome, and chronic inflammatory demyelinating polyneuropathy (CIDP).
- Monitor Neuroinflammatory Diseases: In MS and similar disorders, elevated albumin in CSF can indicate increased permeability of the BBB.
- Differentiate Infections: Elevated CSF albumin levels are more pronounced in bacterial meningitis than in viral cases.
- Evaluate ALS Progression: Recent research highlights a correlation between elevated CSF albumin and poor prognosis in amyotrophic lateral sclerosis, reflecting potential BBB involvement.
Patient Preparation and Instructions
- Preparation: No fasting or dietary restrictions are required. Patients should avoid intense physical activity before the test to minimize discomfort during or after the procedure.
- Inform your provider: Let the healthcare provider know about any medications, allergies, or bleeding disorders.
- Procedure Overview: The test requires a lumbar puncture (spinal tap) to collect cerebrospinal fluid. This is typically performed under sterile conditions in a clinical setting. Patients are asked to remain still during the procedure to ensure accurate sample collection and reduce complications.
Aftercare and Recovery
Post-procedure, patients should:
- Rest quietly for several hours
- Avoid heavy lifting, bending, or strenuous activities for at least 24 hours
- Stay hydrated to reduce the likelihood of post-lumbar puncture headaches
Reference Ranges
Normal CSF albumin levels vary by age and gender, but for adults:
- Typical upper range: ~50 mg/dL
- Common age-specific range: 10–45 mg/dL for adults aged 18–40 (per Labcorp standards)
Interpretation of Results
To accurately assess BBB function, the albumin index is often calculated:
- <9: Normal BBB
- 9–14: Slight impairment
- 14–30: Moderate impairment
- 30–100: Severe impairment
- >100: Complete BBB breakdown
Turnaround Time
Results are typically available within a few days, depending on the laboratory. Faster turnaround may be possible with automated testing platforms.
Specimen Handling and Additional Considerations
- CSF samples must be collected in sterile containers and analyzed promptly to preserve protein integrity.
- For full diagnostic accuracy, serum albumin levels should be tested concurrently.
- The IgG/albumin ratio may also be calculated to help distinguish between immune activation within the CNS and simple BBB disruption.
Order Albumin level/CSF Test
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