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Test Code BETA2 Beta-2 Transferrin: Detection of Spinal Fluid in Other Body Fluid

Reporting Name

Beta-2 Transferrin, BF

Useful For

Detection of spinal fluid in body fluids, such as ear or nasal fluid

Performing Laboratory

Mayo Medical Laboratories in Rochester

Specimen Type

Body Fluid


Specimen Required


Sources: Nasal, Otic, etc

Collection Container/Tube: Pipet, syringe, test tube, or microcollection device

Submission Container/Tube: Plastic vial

Specimen Volume: 0.5 mL

Collection Instructions:

1. If submitting a syringe, remove needle. Add cap to end of syringe.

2. If direct collection is not feasible, specimen may be collected using a cotton swab.

a. Place cotton swab in as small a container as possible (for example, a tightly-stoppered test tube).

b. Do NOT add any additional fluid to swab including, but not limited to, saline or microcollection fluids.

c. Tightly seal container.

Additional Information:

1. Although results may be obtainable on smaller specimens (perhaps as little as 0.05 mL, depending on the protein concentrations and percentage of spinal fluid in the specimen), reliable results are best obtained with an adequate specimen volume.

2. Indicate specimen type.


Specimen Minimum Volume

0.5 mL

Specimen Stability Information

Specimen Type Temperature Time
Body Fluid Frozen (preferred)
  Ambient 
  Refrigerated 

Reference Values

Negative, no beta-2 transferrin (spinal fluid) detected

Day(s) and Time(s) Performed

Monday through Saturday; 1 p.m.

Test Classification

This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the U.S. Food and Drug Administration.

CPT Code Information

86335

LOINC Code Information

Test ID Test Order Name Order LOINC Value
BETA2 Beta-2 Transferrin, BF 13876-8

 

Result ID Test Result Name Result LOINC Value
80351 Beta-2 Transferrin, BF 13876-8

Clinical Information

The diagnosis of cerebrospinal fluid (CSF) rhinorrhea or otorrhea (leakage of CSF into the nose or ear canal, usually as a result of head trauma, tumor, congenital malformation, or surgery) is often difficult to confirm. Traditional chemical analyses (eg, glucose, protein, specific gravity) are unreliable. Radiographic studies, especially those involving the injection of dyes or radiographic compounds, are costly and may introduce additional risks to the patient.

 

Transferrin that migrates in the beta-1 electrophoretic fraction (beta-1 transferrin) is found in most body fluids. Beta-2 transferrin is a CSF-specific variant of transferrin and is used as an endogenous marker of CSF leakage. Beta-2 transferrin is formed by loss of sialic acid due to the presence of neuraminidase in the central nervous system. Beta-2 transferrin has also been called CSF-specific transferrin and tau protein.

 

Prompt diagnosis and localization facilitates appropriate decisions and decreases the risk of meningitis.

Interpretation

The cerebrospinal fluid (CSF) variant of transferrin is identified by its unique electrophoretic migration. If beta-1 and beta-2 transferrin are detected in drainage fluids, the specimen is presumed to be contaminated with CSF.

 

The presence of beta-2 transferrin band is detectable with as little as 2.5% spinal fluid contamination of body fluids.

Clinical Reference

1. Oberascher G: Cerebrospinal fluid otorrhea--new trends in diagnosis. Am J Otol 1988;9:102-108

2. Normansell DE, Stacy EK, Booker CF, et al: Detection of beta-2 transferrin in otorrhea and rhinorrhea in a routine clinical laboratory setting. Clin Diag Lab Immunol 1994;1:68-70

Analytic Time

1 day

Reject Due To

Hemolysis

NA

Lipemia

NA

Icterus

NA

Other

NA

 

Method Name

Electrophoresis/Immunofixation-Peroxidase Antisera/Dimethylformamide Visualization