Desialated transferrin; Asialotransferrin; CSF-specific transferrin; Tau protein; Request for CSF leak
To help identify cerebrospinal fluid (CSF) leaking from the skull.
If there is a watery discharge from your nose or ear (rhinorrhoea or otorrhoea) after you have suffered a skull fracture or after brain surgery.
A sample of the suspicious watery discharge is collected into a plastic tube.
Cerebrospinal fluid (CSF) is normally found only within the brain and the spinal canal. If you suffer an injury which causes a tear in the membranes covering the brain and spine, CSF may leak out. This may sometimes cause watery fluid to drip from either the nose or the ear (rhinorrhoea or otorrhoea). Distinguishing CSF from other watery discharges involves looking for the presence of something which would normally only be found in CSF. Beta-2-transferrin is a form of the protein transferrin that is present in CSF but not usually found in blood, nasal secretions or other body fluids.
The suspicious watery discharge will be collected into a plain plastic tube.
No test preparation is needed.
If you suffer an injury (e.g. skull fracture) which causes a tear in the membranes covering the brain and spine, or have had brain surgery, CSF may leak out. This may cause a watery discharge from your nose or ear (rhinorrhoea or otorrhoea). It may be necessary to distinguish CSF from other watery discharges in these circumstances. This involves looking for the presence of something which would normally only be found in CSF, such as beta-2-transferrin. This is a form of transferrin present in CSF but not usually found in blood, nasal secretions or other body fluids.
Beta-2-transferrin would be requested when there is doubt over the origin of a watery ear or nose discharge, following a high risk event such as a head injury or brain surgery.
If the fluid from the nose or ear is indeed CSF, beta-2-transferrin would be detected when the fluid sample was analysed. Sometimes the result is inconclusive and in such cases the laboratory may test for another protein known as beta trace protein.
CSF leaking from the nose or ear is very rare. Most nasal and ear discharges have an obvious straightforward explanation e.g. infection, and this type of analysis is only required in a very small number of cases where a doctor has a high level of suspicion about the source of discharge.
RCPA manual: Rhinorrhoea CSF Testing
Last Review Date: February 14, 2020