S-100 protein concentration in the cerebrospinal fluid of patients with Creutzfeldt-Jakob disease

被引:94
作者
Otto, M
Stein, H
Szudra, A
Zerr, I
Bodemer, M
Gefeller, O
Poser, S
Kretzschmar, HA
Mader, M
Weber, T
机构
[1] MARIEN HOSP,NEUROL KLIN,D-22087 HAMBURG,GERMANY
[2] UNIV GOTTINGEN,NEUROL KLIN & POLIKLIN,D-3400 GOTTINGEN,GERMANY
[3] UNIV GOTTINGEN,ABT MED STAT,D-3400 GOTTINGEN,GERMANY
[4] UNIV GOTTINGEN,INST NEUROPATHOL,D-3400 GOTTINGEN,GERMANY
关键词
protein S-100; CSF; Creutzfeldt-Jakob disease;
D O I
10.1007/s004150050145
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
We evaluated S-100 levels in paired cerebrospinal fluid (CSF) and serum samples in a group of 135 patients referred to the German Creutzfeldt-Jakob disease (CJD) surveillance unit from June 1993 to May 1995. The patients were seen in a prospective case control study. The diagnosis of probable CJD during life was made in any patient presenting with rapidly progressive dementia of less than 2 years' duration, typical periodic sharp wave complexes (PSWCs) in the EEG and at least two of the following findings: myoclonus, visual/or cerebellar symptoms, pyramidal and/or extrapyramidal signs and/or akinetic mutism. Patients presenting with the above clinical signs and symptoms but without PSWCs were classified as possible, while those with a dementia of a duration exceeding 2 years and without PSWCs were classified as other. S-100 was determined in paired CSF and serum samples by a commercially available enzyme-linked immunosorbent assay. In a group of 76 patients with definite and probable CJD, S-100 concentration (median 25 ng/ml, range 2-117) in CSF was significantly higher (P < 0.0001) than in 32 patients diagnosed as other (median 4 ng/ml, range 1-19). Serum levels of S-100 were below 0.5 ng/ml in all groups. At a cut-off of 8 ng/ml an optimum sensitivity of 84.2% with a specificity of 90.6% for the diagnosis of CJD by the determination of S-100 in CSF is obtained. S-100 levels exceeding 8 ng/ml in CSF support the diagnosis of CJD in any patient presenting with rapidly progressive dementia.
引用
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页码:566 / 570
页数:5
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