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Test Code 0255661 Neuron-Specific Enolase (NSE), Spinal Fluid

Additional Codes

Mayo Test ID
NSESF

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Useful For

An auxillary test in the diagnosis of Creutzfeldt-Jakob disease

 

An auxillary test in the diagnosis of small cell lung carcinoma metastasis to central nervous system or leptomeninges

Method Name

Homogeneous Time-Resolved Fluorescence

Reporting Name

Neuron Specific Enolase, CSF

Specimen Type

CSF


Specimen Required


Container/Tube: Sterile vial

Specimen Volume: 0.5 mL


Specimen Minimum Volume

0.3 mL

Specimen Stability Information

Specimen Type Temperature Time
CSF Refrigerated (preferred) 7 days
  Ambient  72 hours

Reject Due To

Hemolysis

Mild reject; Gross reject

Lipemia

Mild OK; Gross OK

Icterus

Mild reject; Gross reject

Other

NA

Reference Values

Normal: ≤15 ng/mL

Indeterminate: 15-30 ng/mL

Elevated: >30 ng/mL

Elevated results may indicate the need for additional work-up. Possible causes may be NSE-secreting central nervous system/leptomeningeal tumor or rapid neuronal destruction from a variety of causes. In the context of dementia, elevated results may be suggestive of Creutzfeldt-Jakob disease.

Interpretation

The diagnosis of Creutzfeldt-Jakob disease (CJD) is highly complex and involves clinical history and neurologic examination, detection of characteristic periodic sharp and slow wave complexes on electroencephalographs, magnetic resonance imaging (hyperintense basal ganglia), and exclusion of other possible causes of dementia, in addition to cerebrospinal fluid (CSF) examination. Consequently, patients are often diagnosed as having possible, probable, or definite CJD based upon the constellation of clinical findings. Detection of elevated CSF levels of NSE protein in these patients assists in the final diagnosis.

 

A CSF neuron-specific enolase (NSE) within the normal reference range makes sporadic CJD very unlikely, but can be observed in less rapidly progressive forms of CJD, such as variant CJD related to infection with prions that cause bovine spongiform encephalopathy. With the previous Mayo Clinic-developed assay, in a group of carefully pre-selected patients with a probable diagnosis of CJD and an indeterminate or elevated NSE concentration in CSF, the respective diagnostic sensitivities of approximately 87% and approximately 80%, and diagnostic specificities of approximately 66% and approximately 83% were observed.

 

Small cell lung carcinoma central nervous system metastases, particularly if they involve the leptomeninges, will lead to, usually substantial, elevations in CSF NSE concentrations.

Day(s) and Time(s) Performed

Monday through Saturday; 2:30 p.m.

Analytic Time

1 day

Specimen Retention Time

3 months

Test Classification

This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the U.S. Food and Drug Administration.

CPT Code Information

83520

LOINC Code Information

Test ID Test Order Name Order LOINC Value
NSESF Neuron Specific Enolase, CSF 44802-7

 

Result ID Test Result Name Result LOINC Value
NSESF Neuron Specific Enolase, CSF 44802-7

Forms

If not ordering electronically, complete, print, and send a Neurology Specialty Testing Client Test Request (T732) with the specimen.