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Routine analysis of cerebrospinal fluid in CJD is typically normal.
Closer examination of CSF however reveals two proteins, designated 130 and 131 as sensitive and specific markers. Recently these protein markers have been identified as 14-3-3 proteins and an immunoassay has been developed.
This immunoassay was found to be both sensitive and specific for CJD when used in patients with clinical dementia. It is hoped that such an immunoassay may play a role in cases of CJD where there is diagnostic difficulty, and its role in the new variant CJD is yet to be determined.
The main considerations in interpreting the results of 14-3-3 protein analysis are that the test should only be performed in the presence of clinical dementia and that false positives seem to occur in the presence of acute viral encephalitis, or in those who have suffered a stroke within a month of testing. Furthermore it should be noted that some concern has been voiced concerning the transport and stability of 14-3-3 proteins in CSF, perhaps leading to potentially inaccurate results.
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