GLUCOSE, CSF

Code
200.8100
Name
GLUCOSE, CSF
Category
None
Department
Chemistry
Start Date
Expiration Date
Synonyms
GLUCSF
CPT Codes
82945
Site
Main Lab
Reference Test
ATLAS Test Code

Specimen Information

Type

CSF (sterile container)

Volume

1.0 ml

Transport Info

Refrigerated
24 hour stability
Process and analyze immediately

Fasting Required?
False
Patient Instructions

Reference Range

50-80 mg/dL

Methodology

Oxygen Rate

Clinical Significance

Evaluate meningitis, neoplastic involvement of meninges, other neurological disorders; diagnose neuroglycopenia, even in the presence of normal plasma glucose, especially in chlorpropamide (Diabinese) poisoning.

Elevation of CSF glucose implies hyperglycemia 2-4 hours earlier. Significantly decreased cerebrospinal fluid glucose levels are less than 40 mg/dL in fasting patient with normal plasma glucose. Acute viral meningitis is often differentiated from acute bacterial meningitis, because the latter is characterized by a CSF glucose less than 30 mg/dL, a CSF glucose-to-blood glucose ratio less than 0.2-0.3 as well as a protein greater than 200 mg/dL, a CSF polymorphonuclear count greater than 1000/mm3 and an 80% to 90% likelihood of positive Gram's stain, in an illness often occurring during the winter in a child younger than 2 years of age.The gold standard for the diagnosis of bacterial meningitis is the culture. Decreased CSF glucose is characteristically, but not invariably, found in tuberculous, fungal, and amebic meningitis as well as in bacterial meningitis. Glucose is usually normal in viral meningitis, but in herpes or mumps meningoencephalitis, lymphocytic choriomeningitis, and enteroviruses, glucose may be low. Sarcoidosis and neurosyphilis are also reported causes of low CSF glucose. Other very uncommon causes of low CSF glucose include meningeal cysticercosis, trichinosis, and with the chemical meningitis that accompanies intrathecal therapy. Low CSF glucose may also occur in subarachnoid hemorrhage and neoplasia (e.g., medulloblastoma). Low CSF glucose may be found in CNS leukemia. Decrease has led to the diagnosis of insulinoma presenting with CNS symptoms. Rheumatoid meningitis and lupus myelopathy may cause low CSF glucose. CSF glucose levels equal to or less than 20 mg/dL are highly correlated with bacterial meningitis.

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