Beta-2 Transferrin: Detection of Spinal Fluid in Other Body Fluid (BETA2)

Test Code: B2TRNSO

Overview
Ordering
Specimen
Performing
Clinical/Interpretive
Contacts
Coding

Synonyms/Keywords

Ref Lab Code: 80351, B2 Transferrin, Cerebrospinal Fluid Leakage, CSF Specific Transferrin, CSF-Specific Transferrin, Otorrhea, Spinal Fluid,
Rhinorrhea, Spinal Fluid, Tau Protein, Transferrin B2, Transferrin, Spinal Fluid

Useful For

Detection of spinal fluid in body fluids, such as ear or nasal fluid

Specimen Requirements

Specimen Type	Preferred Container/Tube	Acceptable Container/Tube	Specimen Volume	Specimen Minimum Volume (allows for 1 repeat)	Pediatric Minimum Volume (no repeat)
Body fluid (Nasal, otic, etc..)	Pipet, syringe, test tube, or microcollection device		0.5 mL	0.5 mL

Collection Processing Instructions

1. If submitting a syringe, remove needle. Add cap to end of syringe.

2. If direct collection is not feasible, specimen may be collected using a cotton swab.

a. Place cotton swab in a small plastic vial/container (for example, a tightly-stoppered test tube).

b. Do NOT add any additional fluid to swab including, but not limited to, saline or microcollection fluids.

c. Tightly seal container.

Additional Information:

1. Although results may be obtainable on smaller specimens (perhaps as little as 0.05 mL, depending on the protein concentrations and percentage of spinal fluid in the specimen), reliable results are best obtained with an adequate specimen volume.

2. Indicate specimen type.

Specimen Stability Information

Specimen Type	Temperature
Body fluid	Frozen (preferred)
	Ambient
	Refrigerated

Performing Laboratory Information

Performing Location	Day(s) Test Performed	Analytical Time	Methodology/Instrumentation
Mayo Medical Laboratories	Monday through Saturday	1 day	Electrophoresis/Immunofixation-Peroxidase Antisera/Dimethylformamide Visualization

Reference Lab

Mayo Clinic Laboratories

Test Information

The diagnosis of cerebrospinal fluid (CSF) rhinorrhea or otorrhea (leakage of CSF into the nose or ear canal, usually as a result of head trauma, tumor, congenital malformation, or surgery) is often difficult to confirm. Traditional chemical analyses (eg, glucose, protein, specific gravity) are unreliable. Radiographic studies, especially those involving the injection of dyes or radiographic compounds, are costly and may introduce additional risks to the patient.

Transferrin that migrates in the beta-1 electrophoretic fraction (beta-1 transferrin) is found in most body fluids. Beta-2 transferrin is a CSF-specific variant of transferrin and is used as an endogenous marker of CSF leakage. Beta-2 transferrin is formed by loss of sialic acid due to the presence of neuraminidase in the central nervous system. Beta-2 transferrin has also been called CSF-specific transferrin and tau protein.

Prompt diagnosis and localization facilitates appropriate decisions and decreases the risk of meningitis.

Reference Range Information

Negative, no beta-2 transferrin (spinal fluid) detected

Interpretation

The cerebrospinal fluid (CSF) variant of transferrin is identified by its unique electrophoretic migration. If beta-1 and beta-2 transferrin are detected in drainage fluids, the specimen is presumed to be contaminated with CSF.

The presence of beta-2 transferrin band is detectable with as little as 2.5% spinal fluid contamination of body fluids.

Outreach CPTs

CPT	Modifier (if needed)	Quantity	Description	Comments
86335

Synonyms/Keywords

Ordering Applications

Ordering Application	Description
Centricity	Beta-2 Transferrin, BF (BETA2)
Cerner	Beta-2 Transferrin, BF (80351)

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