CSF glucose

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CSF glucose
SCnc
)

CSF glucose or glycorrhachia is a measurement used to determine the concentration of glucose in cerebrospinal fluid (CSF).[1][2][3]

Normal values in humans

Pathophysiology sample values
BMP/ELECTROLYTES:
Na+
= 140 		Cl− = 100 BUN = 20 /
Glu = 150
\
K+ = 4 CO2 = 22 PCr = 1.0
ARTERIAL BLOOD GAS
:
HCO3− = 24 paCO2 = 40 paO2 = 95 pH = 7.40
ALVEOLAR GAS:
pACO2 = 36 pAO2 = 105 A-a g = 10
OTHER:
Ca = 9.5 Mg2+ = 2.0 PO4 = 1
CK = 55 BE = −0.36 AG = 16
SERUM OSMOLARITY/RENAL
:
PMO = 300 PCO = 295
POG
= 5
BUN:Cr
= 20
URINALYSIS:
UNa+ = 80 UCl− = 100 UAG = 5
FENa
= 0.95
UK+ = 25 USG = 1.01 UCr = 60 UO = 800
PROTEIN/GI/LIVER FUNCTION TESTS:
LDH = 100 TP = 7.6 AST = 25 TBIL = 0.7
ALP = 71 Alb = 4.0 ALT = 40 BC = 0.5
AST/ALT = 0.6 BU = 0.2
AF alb
= 3.0 		SAAG = 1.0
SOG
= 60
CSF:
CSF alb = 30 CSF glu = 60 CSF/S alb = 7.5 CSF/S glu = 0.6

The glucose level in CSF is proportional to the

blood glucose level and corresponds to 60-70% of the concentration in blood.[4] Therefore, normal CSF glucose levels lie between 2.5 and 4.4 mmol/L (45–80 mg/dL).[5]

Abnormalities in CSF glucose concentration

Low CSF glucose levels

Hypoglycorrhachia (low CSF glucose levels) can be caused by

GLUT1 deficiency syndrome), increased CNS glycolytic activity and metastatic carcinoma.[4]

CSF glucose levels can be useful in distinguishing among causes of

bacterial meningitis have decreased CSF glucose levels while patients with viral meningitis usually have normal CSF glucose levels. Decrease in glucose levels during a CNS infection is caused due to glycolysis by both white cells and the pathogen, and impaired CSF glucose transport through the blood-brain barrier.[3][6]

High CSF glucose levels

There is no pathologic process that directly leads to hyperglycorrhachia (high CSF glucose levels) and therefore, high CSF glucose levels have no specific diagnostic importance.[3]

However, elevated

blood sugar levels (hyperglycemia) result in elevated CSF glucose levels[3] as the CSF glucose level is proportional to the blood glucose level with glucose being actively transported as well as simply diffusing down the concentration gradient from blood to CSF. In addition, damage to small blood vessels during lumbar puncture (traumatic tap) can lead to an increased CSF glucose since the blood that enters the collected CSF sample contains higher levels of glucose.[4]

CSF glucose levels do not generally exceed 16.7 mmol/L (300 mg/dL).[3]

See also

References

  1. ^ "MedlinePlus Medical Encyclopedia: CSF glucose". Retrieved 2009-03-04.
  2. PMID 14722369
    .
  3. ^
    PMID 14524396. Archived from the original
    on 2008-05-15. Retrieved 2009-03-05.
  4. ^
    ISBN 978-1582558752
    .
  5. ISBN 978-0-07-140816-5
    .
  6. PMID 22316468
    .
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