DIAGNOSIS OF CSF FISTULAS ON THE BASIS OF DETECTION OF BETA(2)-TRANSFERRIN - AGAROSE-GEL ELECTROPHORESIS VERSUS ISOELECTRIC-FOCUSING WITH IMMUNOFIXATION

Determination of beta(2)-transferrin in nasopharyngeal secretions is e stimated to be sensitive for the detection of CSF fistulae. We report a 37-year old man with spontaneous persistent watery secretion from th e nose. Analysis of beta(2)-transferrin by agarose gel electrophoresis with immunofixation was negative. However, analyses of glucose, potas sium, protein and prealbumin compared to blood findings, neuroimaging procedures and positive detection of beta(2)-transferrin by isoelectri c focussing with immunofixation led to the diagnosis of a frontobasal CSF fistula. Application of isoelectric focussing and immunofixation o f O-sialo-transferrin seems to be a more sensitive technique confirmin g liquorrhoea also in the presence of a genetic transferrin variant.