Thank you for the excellent information and for taking time to answer my question from 10/16. Atleast when I ask the question of what is tested, I'll know what response to expect.
What would the significance (if any) of RBC's (count 100) in a clear CSF sample indicate (no trauma, normal pressure)? The only things I have on the report are MBP, oligoclonal bands, glucose and IgG index and synthesis rate. A blood sample was also taken within a few hours of the LP to check for oligoclonal bands in the serum (negative).
Is there any place to get more specific information on the "tourtellote's" panel? I am interested in learning about the different proteins, what they do and what their significance is in the diagnosis of MS.
Usually if the rest of the CSF sample is clean, meaning there's no increase in white blood cell ct or protein, then we refer to the sample with mild increase in rbc's as a traumatic tap. This just means the person who did your spinal tap hit a blood vessel on the way in. Not a big deal, but as neurologists we always try for a clean tap or what we call a "champagne tap." It's a tradition among house officers that a resident who does a clean tap gets a bottle of champagne.
Tourtellote was actually a physician who did a lot of research on CSF findings in MS and thus the immune panel was named after him. It includes IgG index/synthesis, albumin, and ratios. It sounds like most of the important things were already checked in your CSF. At CCF, we simply order a Tourtellote's panel rather than each test separately to look at the immune products. I suggest looking at a medical laboratory book or Fishman's textbook on CSF in diseases of the nervous system. Unfortunately, I could not find a good internet site for this, although you could try writing to the MS society.
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