 |
|
Challenging the Clinical Utility of the 14-3-3 Protein for the Diagnosis of Sporadic Creutzfeldt-Jakob Disease
Michael D. Geschwind, MD, PhD;
Jennifer Martindale, BS;
Deborah Miller, MD;
Stephen J. DeArmond, MD, PhD;
Jane Uyehara-Lock, MD;
David Gaskin, MD;
Joel H. Kramer, PhD;
Nicholas M. Barbaro, MD;
Bruce L. Miller, MD
Arch Neurol. 2003;60:813-816.
Background Creutzfeldt-Jakob disease (CJD) is a rapidly progressive and fatal neurodegenerative disorder for which there is no noninvasive and disease-specific test for premortem diagnosis. Previous studies have suggested that, in the proper clinical context, the 14-3-3 protein in cerebrospinal fluid is a reliable marker for sporadic CJD.
Objective To assess the sensitivity of the cerebrospinal fluid 14-3-3 protein test among patients with definite sporadic CJD.
Design and Setting We reviewed cases of sporadic CJD referred to our institution that were ultimately proved by pathological examination and on which cerebrospinal fluid 14-3-3 testing had been performed.
Participants Patients with CJD referred to our institution for clinical and/or pathological evaluation (biopsy- or autopsy-confirmed diagnosis) from January 1, 1998, through July 15, 2002, and on whom 14-3-3 testing had been performed. Thirty-two such patients with definite sporadic CJD were identified.
Main Outcome Measure The 14-3-3 test results, from various laboratories, in these 32 patients.
Results Seventeen of the 32 patients had a positive result for the 14-3-3 test, yielding a sensitivity of only 53%. A positive 14-3-3 result was significantly correlated with a shorter time between disease onset and the lumbar puncture for the 14-3-3 test.
Conclusions Testing for the 14-3-3 protein is only modestly sensitive to sporadic CJD, and we caution against ruling out a diagnosis of the disease on the basis of a negative 14-3-3 result.
From the Departments of Neurology (Drs Geschwind, D. Miller, Kramer, and B. L. Miller and Ms Martindale), Pathology (Drs DeArmond, Uyehara-Lock, and Gaskin), and Neurosurgery (Dr Barbaro), University of California, San Francisco Medical Center, San Francisco.
RELATED ARTICLE
Cerebrospinal Fluid 14-3-3 Protein: Variability of Sporadic Creutzfeldt-Jakob Disease, Laboratory Standards, and Quantitation
Allen J. Aksamit
Arch Neurol. 2003;60(6):803-804.
EXTRACT
| FULL TEXT
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
Time-course studies of 14-3-3 protein isoforms in cerebrospinal fluid and brain of primates after oral or intracerebral infection with bovine spongiform encephalopathy agent
Yutzy et al.
J. Gen. Virol. 2007;88:3469-3478.
ABSTRACT
| FULL TEXT
A 54-year-old man with slowness of movement and confusion
Geschwind et al.
Neurology 2007;69:1881-1887.
FULL TEXT
CSF tests in the differential diagnosis of Creutzfeldt-Jakob disease.
Sanchez-Juan et al.
Neurology 2006;67:637-643.
ABSTRACT
| FULL TEXT
Diffusion-Weighted and Fluid-Attenuated Inversion Recovery Imaging in Creutzfeldt-Jakob Disease: High Sensitivity and Specificity for Diagnosis
Young et al.
Am. J. Neuroradiol. 2005;26:1551-1562.
ABSTRACT
| FULL TEXT
Immunoglobulins in Urine of Hamsters with Scrapie
Serban et al.
J. Biol. Chem. 2004;279:48817-48820.
ABSTRACT
| FULL TEXT
Sensitivity of 14-3-3 protein test varies in subtypes of sporadic Creutzfeldt-Jakob disease
Castellani et al.
Neurology 2004;63:436-442.
ABSTRACT
| FULL TEXT
Discrepancies in the Clinical Utility of the 14-3-3 Protein for the Diagnosis of Sporadic Creutzfeldt-Jakob Disease
Sanchez-Valle et al.
Arch Neurol 2004;61:604-604.
FULL TEXT
Cerebrospinal Fluid 14-3-3 Protein: Variability of Sporadic Creutzfeldt-Jakob Disease, Laboratory Standards, and Quantitation
Aksamit
Arch Neurol 2003;60:803-804.
FULL TEXT
|
