Abstract
BackgroundCerebrospinal fluid (CSF) can be collected into ethylenediaminetetraacetic acid (EDTA) or plain tubes. The EDTA content presumably contributes to a better cell preservation. EDTA, however, is reported to cause a false elevation in the total protein concentration and to dilute the CSF sample, thereby affecting the diagnostic interpretation. To the authors’ knowledge, no validated studies support this view. The aim of this study was therefore to determine if the choice of tube (EDTA or plain) influences the results of the standard CSF analysis.ResultsThirty-two paired EDTA stabilised and plain CSF samples were included. There was no statistically significant difference in the semi-quantitative protein concentrations when comparing CSF samples from EDTA and plain plastic tubes (P > 0.99). The total nucleated cell count did not differ significantly between EDTA and plain tube samples (P = 0.85). There were no significant differences in the differential cell counts between the two tubes when evaluating polymorphonuclear cells (P = 0.90), lymphocytes (P = 0.84) and monocytes/macrophages (P = 0.86). Also, there was no significant difference in the preservation of cell morphology when evaluating cytological preparations from EDTA stabilised and plain tube samples (P = 0.45).ConclusionsThe collection of CSF into EDTA tubes does not influence the result of the standard CSF analysis. However, a presumed positive effect of EDTA on cell preservation could not be shown in the present study.
Highlights
Cerebrospinal fluid (CSF) can be collected into ethylenediaminetetraacetic acid (EDTA) or plain tubes.The EDTA content presumably contributes to a better cell preservation
The collection of CSF into EDTA tubes does not influence the result of the standard CSF analysis
A presumed positive effect of EDTA on cell preservation could not be shown in the present study
Summary
Cerebrospinal fluid (CSF) can be collected into ethylenediaminetetraacetic acid (EDTA) or plain tubes.The EDTA content presumably contributes to a better cell preservation. The aim of this study was to determine if the choice of tube (EDTA or plain) influences the results of the standard CSF analysis. Cerebrospinal fluid (CSF) analysis is pivotal in the diagnostic work-up of patients with central nervous system (CNS) signs, and CSF should be collected and analysed whenever an infectious or inflammatory disease, neoplasia or degenerative disorder of the brain or spinal cord is suspected [1, 2]. A standard CSF analysis includes a total nucleated cell (TNC) count, a protein concentration measurement, a University Hospital for Companion Animals, Department of Veterinary. The TNC count and protein concentration can be elevated in the presence of infectious or inflammatory CNS disease, due to an increase in permeability of the blood brain barrier. A cytological CSF examination is essential even in the presence of a normal TNC count, as abnormalities in cell types and structure can indicate CNS disease [2, 7, 8]
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