14-3-3 CSF Protein Test

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NATA/RCPA Accreditation No. 19256

What is the 14-3-3 protein CSF test?

The 14-3-3 protein is an ante-mortem, non-specific marker of central nervous system neuronal injury or death. Based on international experience in carefully selected patients, a positive result has approximately 90% sensitivity and specificity for sporadic Creutzfeldt Jakob disease. False positives are recognized in various disease processes; for example encephalitis, encephalopathies and recent cerebral infarcts. Unselected sampling is consequently less reliable if the 14-3-3 protein CSF test is used to screen for a possible diagnosis of CJD.

In February 2010, evaluation of all 2002-2008 Australian CSF referrals where a known clinical outcome was provided to the ANCJDR after detailed followup, revealed a test sensitivity of 88.5% and specificity of 87.6%.

The sample

  • No less than 1 ml of CSF – PLEASE DO NOT SPIN SAMPLE.
  • CSF samples are to be packaged in polypropylene, sterile tubes with no additives.
  • Double bag, freeze and transport frozen on dry ice. You are responsible for organizing your courier service to pick up and deliver the sample to The University of Melbourne.
  • Please provide routine cell counts and protein levels. These results are needed for interpretation.
  • A copy of the original request slip and a completed specimen data sheet should accompany the sample. Please provide accurate billing details with accompanying documentation.

Information about the test

  • The test is run weekly.
  • Samples received by 4pm Friday will have the result issued by the end of the following week.
  • All salient clinical details are clarified with the requesting doctor. A researcher from the Registry will contact the clinician directly.
  • Positive and medically significant results will be verbally reported to the requesting clinician within 24-48 hours and a report mailed to the referring laboratory.
  • All results will be reported by post to the referring laboratory.

Unsuitable samples

Unsuitable samples will not be tested. All samples are screened on receipt and those considered unsuitable will be disposed of. The referring clinician will be contacted upon receipt of such a sample and advised. A report will be issued.

An unsuitable sample will include the following:

  • Macroscopically haemorrhagic samples
  • Xanthochromic samples
  • Red blood cell counts >500 cells per µl
  • White cell counts >10 cells per µl

Based on cumulative experience and published results, these samples are unsuitable to test due to the 14-3-3 protein existing in erythrocytes, platelets and plasma. Lysis of these cells releases the protein thus contaminating the CSF sample and giving a false positive result. (Day I.N.M and Thompson R.J. Clinica Chimica Acta 1984; 136: 219-228, Collins et al, J of Clin Neurosci 2000; 7:203-208).

Reporting Results

  • Please directly contact your referring laboratory to check for results.
  • Technical difficulties may cause delays in reporting. These delays cannot be predetermined and the test will be repeated until a satisfactory result is obtained.

Please notify samples being sent, and courier addressed to:

The Australian National CJD Registry
The Florey Institute of Neuroscience and Mental Health
The University of Melbourne
Melbourne Brain Centre (Kenneth Myer Building)
Cnr Genetics Lane and Royal Parade
Gate 11, Rear Loading dock
Parkville, Victoria 3052

Phone: (03) 8344 1949
Fax: (03) 9349 5105

Specimen Data Sheet

This form must accompany specimens sent for testing (download specimen data sheet here).  The PDF document contains form fields allowing for completion of some or all fields prior to printing.