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Lab Manual for SFGH

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CEREBROSPINAL FLUID (CSF) - CELL COUNT AND APPEARANCE

Item Value
Approval req'd? no
Available Stat? Yes
Test code SCSF
Performed by? Hematology
Sendout? no
Price range $
In House Availability 24 hours/7 days
Principle 1. Evaluation of appearance.

2. Manual or automated cell count. Automated cell count is performed on the ADVIA 2120 cell counting system, using light scattering and absorbance measurements.
Interpretation 1. Grossly bloody fluid

a. If caused by traumatic tap, tends to clear progressively as CSF is withdrawn and has a clear supernatant after centrifugation.

b. If caused by subarachnoid hemorrhage, the distribution of blood is uniform in all tubes and supernatant is yellow (xanthochromic).

2. Turbid fluids usually indicate increased WBCs.

3. Xanthochromic (yellow) fluids after centrifugation indicate: subarachnoid hemorrhage, severe jaundice, or high protein. Almost any fluid with a protein over 150,000 mg/L will be slightly yellow.

4. Clots will form in CSF with high protein levels.

5. Bleeding into CSF is associated with a corresponding increase in CSF protein, about 1000 mg/L per 700 RBC/cmm.
Container type lumbar puncture kit, clear plastic tube
Preferred volume 1-3 mL per tube
Special instructions 1. Number tubes in sequence as withdrawn.

2. If there is any indication at bedside that the fluid might clot, place the sample for cell count in an EDTA tube (lavender) and mix well. Clotted fluids will not be counted.

3. The last tube withdrawn, tube #4, is used for cell count.

4. CSF collected in a black screw-top tube (no anticoagulant) is acceptable
Normal range
Conventional Units SI Units
Appearance colorless/clear colorless/clear
RBC 0/cmm 0.000 x 109 /mcL
WBC (adults) 0-5/cmm 0.000 0.005 x109 /mcL
(neonates) 0-30/cmm 0.000 0.030 x109 /mcL


Leukocyte differential count:
Adults
lymphocytes 40 - 80%
monocytes/macrophages 15 - 45%
neutrophils 0 - 6%
eosinophils 0 - 1%
basophils 0 - 1%


Neonates
lymphocytes 5 - 35%
monocytes/macrophages 50 - 90%
neutrophils 0 - 8%
eosinophils 0 - 1%
basophils 0 - 1%

Synonyms CSF;
Stability Should be examined for cell count within 30 minutes. Deliver immediately to the Lab.
Additional information INDICATIONS: In general, inflammatory diseases, hemorrhage, neoplasms, and trauma bring about an elevated cell count and a change in appearance.
References 1. Kjeldsberg, C.R., Knight, J.A. Body Fluids, Laboratory Examination of Amniotic, Cerebrospinal, Seminal, Serous, and Synovial Fluids: A Textbook Atlas. 3rd ed. Chicago: American Society of Clinical Pathologists Press. 1993:65-157.

2. Clinical Diagnosis and Management by Laboratory Methods. Henry, JB (ed.). 20th ed. Philadelphia: W. B. Saunders. 2001:403-424.
CPT coding 89051

Last Updated 9/28/2010 7:40:48 AM
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