Have you heard of this?

Hi Cheryl-did they do any diabetic screening?

At least with a low protein, you are doing something right. Was your protein high in your first lp?

I did a quick Google search for nucleated cells in lumbar puncture and from what I can tell fewer than 5 per ml is normal.

Here is the website I found that info at:

[url]http://www.uwo.ca/cns/resident/pocketbook/disorders/investigations/lumbar%20puncture.html[/url]

If you scroll down you’ll find this text:

Normal values

– Opening pressure: 5-20 cm water (only valid in lateral decubitus position)

– Appearance: clear, colorless

– Nucleated cells: <5 per ml

- RBC: <5 per ml

- WBC:RBC ratio: 1:700 (ie. For every additional 700 RBCs seen due to presumed traumatic tap, one WBC is expected)

- Glucose: 2/3 serum value

- Protein: 200-450 mg/L

Then I did a Google search for glucose levels in lumbar puncture. It seems if you have elevated glucose levels show up it's normal.

Here's the website:

[url]http://emedicine.medscape.com/article/1189617-overview[/url]

And the text explaining it:

CSF glucose level normally approximates 60% of the peripheral blood glucose level at the time of the tap. A simultaneous measurement of blood glucose (especially if the CSF glucose level is likely to be low) is recommended. Low CSF glucose level usually is associated with bacterial infection (probably due to enzymatic inhibition rather that actual bacterial consumption of the glucose). It also is seen in tumor infiltration, and may be one of the hallmarks of meningeal carcinomatosis, even with negative cytologic findings. High CSF glucose level has no specific diagnostic significance and is most often spillover from elevated blood glucose level.

Hope that helps.
Kelly

No problemo! Glad I could help.

Kelly

I agree with Kelly, except that the number is less than 5 per microliter not milliliter for both nucleated cells (WBC) and for RBC in the CSF.

Most of the time, the cell differential is reported as WBC instead of nucleated cells and the number of each kind is reported–for example, number of lymphocytes, number of monocytes, and number of polymorphonuclear (PMN) or poly or neutrophils (all three nicknames for the same type of cell). People worry about bacterial meningitis is the number of polys is really high. Our lab occassionally reports non-hematologic nucleated cells as well. These can be lining cells of the spinal cord, but most often are “clean up cells” after there has been irritation of the spinal lining. If this is what your nucleated cells are, the picture is one of healing–low (inflammatory) protein, clean-up cells present to get rid of older damage, and higher glucose (which can be associated with fewer cells in the spinal fluid to use up the glucose).

As Kelly and Emma point out, higher glucose has to taken in context with your serum glucose AT THAT TIME. Often the serum glucose used to compare was at hours different in time. Also, if the CSF is “delayed” in going to the lab, the glucose will be higher and the protein may be a little higher (because of breakage of the fragile cells in the spinal fluid).

WithHope

Well heck…I thought I was always right….NOT!

You know what is confusing? Isn’t ml used as milliliter? How are average people supposed to know the difference between milliliter and microliter?

Thanks for clearing that up WithHope.

Kelly

[quote=Emily’s_mom]Well heck…I thought I was always right….NOT!

You know what is confusing? Isn’t ml used as milliliter? How are average people supposed to know the difference between milliliter and microliter?

Thanks for clearing that up WithHope.

Kelly[/quote]

Hi Kelly,

A microliter is 1/1000 of a milliliter. Microliter has a different abbreviation, which uses a symbol that isn’t on my keyboard. Here’s a conversion table.

[URL=”http://www.metric-conversions.org/volume/microliters-conversion.htm”]http://www.metric-conversions.org/volume/microliters-conversion.htm[/URL]

Thanks Rod, I’m familiar with that site. I have to use it often.

I copy & pasted the info I posted on nucleated cells. So maybe the website I went to was wrong or they also didn’t have the capability to write the measurement correctly.

I’m glad WithHope is here to help clear these kinds of mistakes up though.

Kelly

As was pointed out, one milliliter is 1/1000 of a liter. One microliter is 1/1000 of a milliliter. The generally accepted symbol for “micro” is the lower case Greek letter mu. For most fonts in Windows, you can type mu by holding down the Alt key and typing, on the keypad, 230, then releasing the Alt key. Another symbol you might see, especially in medical settings, “mc”. If you take a thyroid replacement, you might be taking 75 mcg or 75 micrograms.

MarkEns