caa a22 4500 445809795 CHVBK 20180317145208.0 cr unu---uuuuu 170323e20110801xx s 000 0 eng 10.1007/s00415-011-5970-8 doi (NATIONALLICENCE)springer-10.1007/s00415-011-5970-8 Addition of serum-containing medium to cerebrospinal fluid prevents cellular loss over time [Elektronische Daten] [Marieke de Graaf, Patricia van den Broek, Jaco Kraan, Ronald Luitwieler, Martin van den Bent, Joke Boonstra, Paul Schmitz, Jan Gratama, Peter Sillevis Smitt] Immediately after sampling, leukocyte counts in native cerebrospinal fluid (CSF) start to decrease rapidly. As the time lapse between CSF collection to analysis is not routinely registered, the clinical significance of decreasing cell counts in native CSF is not known. Earlier data suggest that addition of serum-containing medium to CSF directly after sampling prevents this rapid decrease in leukocyte counts and, thus, may improve the accuracy of CSF cell counting and cell characterization. Here, we prospectively examined the effect of storage time after lumbar puncture on counts of leukocytes and their major subsets in both native CSF and after immediate addition of serum-containing medium, measured by flow cytometry and microscopy. We collected CSF samples of 69 patients in tubes with and tubes without serum-containing medium and determined counts of leukocytes and subsets at 30minutes, 1 hour, and 5hours after sampling. Compared to cell counts at 30minutes, no significant decrease in cell number was observed in CSF with serum-containing medium 1 and 5hours after sampling, except for the granulocytes at 1hour. In native CSF, approximately 50% of leukocytes and all their subsets were lost after 1hour, both in flow cytometric and microscopic counting. In 6/7 (86%) samples with mild pleocytosis (5-15×106 leukocytes/l), native CSF at 1hour was incorrectly diagnosed as normocellular. In conclusion, addition of serum-containing medium to CSF directly after sampling prevents cell loss and allows longer preservation of CSF cells prior to analysis, both for microscopic and flow cytometric enumeration. We suggest that this protocol results in more accurate CSF cell counts and may prevent incorrect conclusions based on underestimated CSF cell counts. The Author(s), 2011 Cerebrospinal fluid nationallicence Leukocytes nationallicence Flow cytometry nationallicence Lumbar puncture nationallicence de Graaf Marieke Department of Neurology, Erasmus University Medical Center, Room H-639, ‘s-Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands aut van den Broek Patricia Department of Medical Oncology, Erasmus University Medical Center, Rotterdam, The Netherlands aut Kraan Jaco Department of Medical Oncology, Erasmus University Medical Center, Rotterdam, The Netherlands aut Luitwieler Ronald Department of Anesthesiology, Sint Franciscus Gasthuis, Rotterdam, The Netherlands aut van den Bent Martin Department of Neurology, Erasmus University Medical Center, Room H-639, ‘s-Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands aut Boonstra Joke Department of Clinical Chemistry, Erasmus University Medical Center, Rotterdam, The Netherlands aut Schmitz Paul Department of Trials and Statistics, Erasmus University Medical Center, Rotterdam, The Netherlands aut Gratama Jan Department of Medical Oncology, Erasmus University Medical Center, Rotterdam, The Netherlands aut Sillevis Smitt Peter Department of Neurology, Erasmus University Medical Center, Room H-639, ‘s-Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands aut Journal of Neurology Springer-Verlag 258/8(2011-08-01), 1507-1512 0340-5354 258:8<1507 2011 258 415 https://doi.org/10.1007/s00415-011-5970-8 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00415-011-5970-8 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- de Graaf Marieke Department of Neurology, Erasmus University Medical Center, Room H-639, ‘s-Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands aut NATIONALLICENCE 700 1- van den Broek Patricia Department of Medical Oncology, Erasmus University Medical Center, Rotterdam, The Netherlands aut NATIONALLICENCE 700 1- Kraan Jaco Department of Medical Oncology, Erasmus University Medical Center, Rotterdam, The Netherlands aut NATIONALLICENCE 700 1- Luitwieler Ronald Department of Anesthesiology, Sint Franciscus Gasthuis, Rotterdam, The Netherlands aut NATIONALLICENCE 700 1- van den Bent Martin Department of Neurology, Erasmus University Medical Center, Room H-639, ‘s-Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands aut NATIONALLICENCE 700 1- Boonstra Joke Department of Clinical Chemistry, Erasmus University Medical Center, Rotterdam, The Netherlands aut NATIONALLICENCE 700 1- Schmitz Paul Department of Trials and Statistics, Erasmus University Medical Center, Rotterdam, The Netherlands aut NATIONALLICENCE 700 1- Gratama Jan Department of Medical Oncology, Erasmus University Medical Center, Rotterdam, The Netherlands aut NATIONALLICENCE 700 1- Sillevis Smitt Peter Department of Neurology, Erasmus University Medical Center, Room H-639, ‘s-Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands aut NATIONALLICENCE 773 0- Journal of Neurology Springer-Verlag 258/8(2011-08-01), 1507-1512 0340-5354 258:8<1507 2011 258 415 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer