BETA-2 TRANSFERRIN ASSAY IN CLINICAL MANAGEMENT OF CEREBRAL SPINAL-FLUID AND PERILYMPHATIC FLUID LEAKS

Beta-2 transferrin is a protein found in cerebral spinal fluid (CSF) a nd inner ear perilymph, but not in blood, nasal or ear secretions. The purpose of this paper is to evaluate the clinical usefulness of the c urrent assay for beta-2 transferrin for detecting CSF and perilymphati c leaks. We reviewed the hospital records of the first 88 patients hav ing specimens submitted for beta-2 transferrin analysis at our institu tion. Both CSF and perilymph leaks were identified. However, confirmat ion of the absence or presence of beta-2 transferrin was directly used in the clinical management of only 55% of the patients. This was larg ely secondary to the time delay in test processing and initial lack of physician confidence with the test. However, our review of the clinic al outcomes relating to the use of the beta-2 transferrin analysis sug gests high sensitivity and specificity for the test. Analysis of beta- 2 transferrin appears to be a valuable test for detecting CSF leakage and a promising test for confirming perilymphatic leaks. However, to a chieve greater clinical usefulness a rapid clinical assay needs to be developed and further information gained regarding the sensitivity and specificity of the beta-2 transferrin assay for detecting CSF and per ilymphatic fluid leakage.