Mention the recent confirmatory tests for CSF rhinorrhoea.

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Beta 2 transferrin : sensitivity  100% , specification 95%

Beta 2 transfer is produced by neuraminidase activity within CNS. Therefore it is only present in :

  • CSF
  • Perilymph
  • Aqueous humor

This B2 transferrin is pathognomonic for CSF

  • Highly sensitive , specific and non invasive and rapid.
  • A minimum 0.5ml of fluid is necessary for electrophoresis
  • However does not provide information regarding the site or laterally of the defect .
  • Certain condition causing abnormal transferrin metabolism leading to false +ve result are inborn error of glycogen metabolism.

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