NR ANXX
AU Geschwind,M.D.; Martindale,J.; Miller,D.; DeArmond,S.J.; Uyehara-Lock,J.H.; Gaskin,D.; Kramer,J.H.; Barbaro,N.M.; Miller,B.L.
TI Challenging the clinical utility of the 14-3-3 protein for the diagnosis of sporadic Creutzfeldt-Jakob disease
QU Archives of Neurology 2003 Jun; 60(6): 813-6
KI Arch Neurol. 2003 Jun;60(6): 803-4. PMID: 12810481
PT journal article
AB BACKGROUND: Creutzfeldt-Jakob disease (CJD) is a rapidly progressive and fatal neurodegenerative disorder for which there is no noninvasive and disease-specific test for premortem diagnosis. Previous studies have suggested that, in the proper clinical context, the 14-3-3 protein in cerebrospinal fluid is a reliable marker for sporadic CJD. OBJECTIVE: To assess the sensitivity of the cerebrospinal fluid 14-3-3 protein test among patients with definite sporadic CJD. DESIGN AND SETTING: We reviewed cases of sporadic CJD referred to our institution that were ultimately proved by pathological examination and on which cerebrospinal fluid 14-3-3 testing had been performed. PARTICIPANTS: Patients with CJD referred to our institution for clinical and/or pathological evaluation (biopsy- or autopsy-confirmed diagnosis) from January 1, 1998, through July 15, 2002, and on whom 14-3-3 testing had been performed. Thirty-two such patients with definite sporadic CJD were identified. Main Outcome Measure The 14-3-3 test results, from various laboratories, in these 32 patients. RESULTS: Seventeen of the 32 patients had a positive result for the 14-3-3 test, yielding a sensitivity of only 53%. A positive 14-3-3 result was significantly correlated with a shorter time between disease onset and the lumbar puncture for the 14-3-3 test. CONCLUSIONS: Testing for the 14-3-3 protein is only modestly sensitive to sporadic CJD, and we caution against ruling out a diagnosis of the disease on the basis of a negative 14-3-3 result.
MH Adult; Aged; Biological Markers; Creutzfeldt-Jakob Syndrome/*cerebrospinal fluid/*diagnosis/pathology; Enzyme-Linked Immunosorbent Assay; Female; Human; Immunoblotting; Laboratory Techniques and Procedures/standards; Male; Middle Age; Reference Standards; Support, Non-U.S. Gov't; Support, U.S. Gov't, P.H.S.; Tyrosine 3-Monooxygenase/*cerebrospinal fluid; United States
AD Department of Neurology, Pathology, and Neurosurgery, University of California, San Francisco Medical Center, San Francisco, CA 94143, USA. mgeschwind@memory.ucsf.edu
SP englisch
PO USA