14-3-3 Protein
Label Mnemonic: P1433
Epic Lab Code: LAB2500
Downtime Form: A-1a Miscellaneous Request
Commercial Mail-out Laboratory
5231 RCP
356-8593
Specimen(s):
Spinal Fluid
Collection Medium:
CSF collection kit
Minimum:
1.0 mL spinal fluid from collection vial #2.
Delivery Instructions:
Preferred submission to lab on ice.
Turn Around Time:
4 working days upon receipt at reference laboratory
Reference Range:
Normal: < or = 2.0 ng/mL

Elevated: > 2.0 ng/mL
Interpretive Data:
Useful for supporting, in conjunction with other tests, a diagnosis of Creutzfeldt-Jakob disease in patients with rapidly progressive dementia when other neurodegenerative conditions have been excluded.

Please see the USA Centers of Disease Control and Prevention information on Creutzfeldt- Jakob Disease, Classic (CJD).

There is no established role for 14-3-3 measurement in the diagnosis of acquired or inherited CJD.
Comments:
Hemolyzed specimens will be rejected. Hemolysis causes falsely- elevated 14-3-3 results. The 14-3-3 concentrations in 82 visibly blood- tinged cerebrospinal fluid (CSF) specimens were up to 281 ng/mL, with 74 specimens (90.2%) showing levels above the cutoff.

In addition, specimens may be determined to be unsuitable for testing if any of the following conditions are observed:(1,2)
-Macroscopically hemorrhagi
-Xanthochromic
-RBC counts >500 cells per mcL
-WBC counts >10 cells per mcL

Regardless of the method used, measurement of 14-3-3 protein in CSF should not be relied upon exclusively to establish the diagnosis of Creutzfeldt-Jakob disease (CJD). Increased concentrations of 14-3-3 protein in CSF have been described in a variety of central nervous system (CNS) diseases other than CJD that are associated with relative rapid (days to months, rather than months to years) destruction of significant amounts of CNS neuronal tissue. Published examples include: infectious encephalitides, transverse myelitis, stroke, intracerebral and subarachnoid hemorrhage, rapidly progressive vascular dementia, various metabolic and anoxic encephalopathies, severe acute CNS episodes of multiple sclerosis, cerebral vasculitides and angiopathies, mitochondrial encephalomyelopathies, CNS storage diseases, widespread or rapidly growing primary or secondary CNS and leptomeningeal tumors, and, rarely, Alzheimer disease and other primary dementias.
Methodology:
Immunochemiluminometric Assay (ICMA)
CPT Code:
83520