Albumin Level, Cerebral Spinal Fluid (CSF) Test

Albumin Level/Cerebrospinal Fluid Test Description

The albumin level, CSF test, measures the concentration of albumin in cerebrospinal fluid (CSF). Albumin is a protein primarily produced by the liver and is the most abundant protein in CSF.

Since albumin is not synthesized within the central nervous system, its presence in CSF is indicative of blood-brain barrier (BBB) integrity. This test is crucial for assessing the permeability of the BBB and can help diagnose conditions associated with BBB dysfunction.

The BBB is a highly selective barrier that separates the brain from the bloodstream, protecting the brain from harmful substances. This can occur in various neurological conditions, including infections, inflammation, and degenerative diseases.

The Albumin Level-Cerebral Spinal Fluid (CSF) Test Indications

• Blood-Brain Barrier Dysfunction: Elevated CSF albumin levels indicate compromised BBB integrity, which can occur in conditions such as multiple sclerosis, Guillain-Barré syndrome, and chronic inflammatory demyelinating polyneuropathy (CIDP).

• Neuroinflammatory Diseases: Useful in diagnosing and monitoring diseases like multiple sclerosis, where elevated CSF albumin levels may suggest increased BBB permeability.

• Infections and Inflammations: Helps differentiate between bacterial and viral meningitis by assessing protein levels in CSF. Elevated albumin levels are more commonly associated with bacterial meningitis.

• Amyotrophic Lateral Sclerosis (ALS): Recent studies have shown that elevated CSF albumin levels can be a poor prognostic indicator for the progression of ALS, highlighting the potential role of BBB dysfunction in the disease’s pathophysiology

Patient Preparation/Instructions

• Preparation: No specific dietary restrictions are required, but patients should avoid strenuous activities before the procedure to minimize potential discomfort.

• Procedure

• A lumbar puncture (spinal tap) is performed to collect CSF.

• Patients should remain still and follow the healthcare provider’s instructions during the procedure. It is essential to inform the healthcare provider about any medications or allergies before undergoing the procedure.

• Post-Procedure

• Rest for a few hours after the procedure to minimize potential side effects like headache.

• Patients should also avoid heavy lifting or bending to reduce the risk of complications.

Typical Reference Values

The normal range for CSF albumin varies slightly depending on age and gender. Generally, the reference values are as follows:

• Adults: The upper normal range is typically around 50 mg/dL

• Age-Specific Ranges: According to Labcorp, the reference intervals vary by age and gender, with ranges such as 10–45 mg/dL for adults aged 18 to 40 years.

Interpretation of Results

The interpretation of CSF albumin levels often involves calculating the albumin index, which compares the concentration of albumin in CSF to that in serum. This index helps assess the degree of BBB impairment:

• Albumin Index: Calculated by dividing the CSF albumin concentration (in mg/dL) by the serum albumin concentration (in g/dL). An index value:

  • <9 is considered normal, indicating an intact BBB.

  • 9–14 suggests slight impairment.

  • 14–30 indicates moderate impairment.

  • 30–100 suggests severe impairment.

  • >100 indicates a complete breakdown of the BBB1.

Turnaround Time

The turnaround time for this test can vary depending on the laboratory but is generally available within a few days. Some laboratories may provide results more quickly, especially if the test is performed using automated systems.

Clinical Utility

The CSF albumin test is particularly useful when combined with other CSF analyses, such as IgG levels. The IgG/albumin ratio can help differentiate between conditions like multiple sclerosis, where local IgG production is increased, and conditions with BBB disruption, where both IgG and albumin levels are elevated.

Additional Considerations

         Specimen Handling

CSF specimens should be collected in sterile tubes and submitted to the laboratory as soon as possible to prevent contamination and degradation of proteins.

         Comparison with Serum Albumin

For a comprehensive assessment of BBB integrity, it is recommended to compare CSF albumin levels with serum albumin concentrations simultaneously.

In conclusion, the Albumin Level, CSF test is a valuable diagnostic tool for assessing BBB integrity and diagnosing neurological conditions associated with BBB dysfunction.

Its utility extends beyond standalone measurements, often requiring correlation with serum albumin levels and other CSF parameters for comprehensive interpretation.

Order Albumin level/CSF Test

Please click the ‘Order Test’ button and put the immunofluorescence analysis in Michel’s medium in your cart.

You are welcome to visit our laboratory in Kilimani, Nairobi.

This will initiate the process for obtaining your test.