Test ID: BETA2
Beta-2 Transferrin: Detection of Spinal Fluid in Other Body Fluid
Secondary ID 
A test code used for billing and in test definitions created prior to November 2011
NY State Approved Indicates the status of NY State approval and if the test is orderable for NY State clients.
Useful For Suggests clinical disorders or settings where the test may be helpful
Detection of spinal fluid in body fluids, such as ear or nasal fluid
Method Name A short description of the method used to perform the test
Electrophoresis/Immunofixation-Peroxidase Antisera/Dimethylformamide Visualization
Reporting Name A shorter/abbreviated version of the Published Name for a test; an abbreviated test name
Aliases Lists additional common names for a test, as an aid in searching
Cerebrospinal Fluid Leakage
CSF Specific Transferrin
CSF-Specific Transferrin
Otorrhea, Spinal Fluid
Rhinorrhea, Spinal Fluid
Tau Protein
Transferrin B2
Transferrin, Spinal Fluid
Specimen Type Describes the specimen type needed for testing
Specimen Required Defines the optimal specimen. This field describes the type of specimen required to perform the test and the preferred volume to complete testing. The volume allows automated processing, fastest throughput and, when indicated, repeat or reflex testing.
Sources: Nasal, otic, etc.
Collection Container/Tube: Pipet, syringe, test tube, or microcollection device
Submission Container/Tube: Plastic vial
Specimen Volume: 0.5 mL
Collection Instructions:
1. If submitting a syringe, remove needle. Add cap to end of syringe.
2. If direct collection is not feasible, specimen may be collected using a cotton swab.
a. Place cotton swab in as small a container as possible (for example, a tightly-stoppered test tube).
b. Do NOT add any additional fluid to swab including, but not limited to, saline or microcollection fluids.
c. Tightly seal container.
Additional Information:
1. Although results may be obtainable on smaller specimens (perhaps as little as 0.05 mL, depending on the protein concentrations and percentage of spinal fluid in the specimen), reliable results are best obtained with an adequate specimen volume.
2. Indicate specimen type.
Forms: If not ordering electronically, submit a General Request Form (Supply T239) with the specimen.
Specimen Minimum Volume Defines the amount of specimen required to perform an assay once, including instrument and container dead space. Submitting the minimum specimen volume makes it impossible to repeat the test or perform confirmatory or perform reflex testing. In some situations, a minimum specimen volume may result in a QNS (quantity not sufficient) result, requiring a second specimen to be collected.
Reject Due To Identifies specimen types and conditions that may cause the specimen to be rejected
| Hemolysis | NA |
| Lipemia | NA |
| Icterus | NA |
| Other | NA |
Specimen Stability Information Provides a description of the temperatures required to transport a specimen to the laboratory. Alternate acceptable temperature(s) are also included.
| Specimen Type | Temperature | Time |
|---|---|---|
| Body Fluid | Frozen (preferred) | |
| Ambient | ||
| Refrigerated | ||
Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test
The diagnosis of cerebrospinal fluid (CSF) rhinorrhea or otorrhea (leakage of CSF into the nose or ear canal, usually as a result of head trauma, tumor, congenital malformation, or surgery) is often difficult to confirm. Traditional chemical analyses (eg, glucose, protein, specific gravity) are unreliable. Radiographic studies, especially those involving the injection of dyes or radiographic compounds, are costly and may introduce additional risks to the patient.
Transferrin that migrates in the beta-1 electrophoretic fraction (beta-1 transferrin) is found in most body fluids. Beta-2 transferrin is a CSF-specific variant of transferrin and is used as an endogenous marker of CSF leakage. Beta-2 transferrin is formed by loss of sialic acid due to the presence of neuraminidase in the central nervous system. Beta-2 transferrin has also been called CSF-specific transferrin and tau protein.
Prompt diagnosis and localization facilitates appropriate decisions and decreases the risk of meningitis.
Reference Values Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.
Negative, no beta-2 transferrin (spinal fluid) detected
Interpretation Provides information to assist in interpretation of the test results
The cerebrospinal fluid (CSF) variant of transferrin is identified by its unique electrophoretic migration. If beta-1 and beta-2 transferrin are detected in drainage fluids, the specimen is presumed to be contaminated with CSF.
The presence of beta-2 transferrin band is detectable with as little as 2.5% spinal fluid contamination of body fluids.
Cautions Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances
Beta-2 transferrin is also found in aqueous humor and in serum of patients with rare metabolic glycoprotein disorders or genetic variants of transferrin.
Beta-2 transferrin may be undetectable if the specimen is diluted by saliva and not frozen after collection.
Supportive Data
Mayo studies comparing this immuno-enzyme detection method to our previous immunofixation-silver stain method indicate that the immuno-enzyme method is 10-fold more sensitive, as well as faster to perform (2.5 hours versus 4.5 hours).
Clinical Reference Provides recommendations for further in-depth reading of a clinical nature
1. Oberascher G: Cerebrospinal fluid otorrhea--new trends in diagnosis. Am J Otol 1988;9:102-108
2. Normansell DE, Stacy EK, Booker CF, et al: Detection of beta-2 transferrin in otorrhea and rhinorrhea in a routine clinical laboratory setting. Clin Diag Lab Immunol 1994;1:68-70
Method Description Describes how the test is performed and provides a method-specific reference
Specimens are electrophoresed using a high resolution 1% agarose gel, immunofixed with an antiserum to human transferrin that is conjugated with horse radish peroxidase. This reagent set is provided by Sebia (Hydrogel 6 CSF kit).(Meurman OH, Irjala K, Suonpaa J, Laurent B: A new method for the identification of cerebrospinal fluid leakage. Acta Otolaryngol [Stockholm] 1979;87:266-369. Reisinger PW, Hochstrasser K: The diagnosis of CSF fistulae on the basis of detection of beta-2 transferrin by polyacrylamide gel electrophoresis and immunoblotting. J Clin Chem Clin Biochem 1989;27:169-172)
Day(s) and Time(s) Test Performed Outlines the days and times the test is performed. This field reflects the day and time the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time required before the test is performed. Some tests are listed as continuously performed, which means assays are performed several times during the day.
Monday through Saturday; 1 p.m.
Analytic Time Defines the amount of time it takes the laboratory to setup and perform the test. This is defined in number of days. The shortest interval of time expressed is "same day/1 day," which means the results may be available the same day that the sample is received in the testing laboratory. One day means results are available 1 day after the sample is received in the laboratory.
Maximum Laboratory Time Defines the maximum time from specimen receipt at Mayo Medical Laboratories until the release of the test result
Specimen Retention Time Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded
Performing Laboratory Location The location of the laboratory that performs the test
Test Classification Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer's instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR), Investigation Use Only (IUO) product, or a Research Use Only (RUO) product.
CPT Code Information Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Medical Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.
86335
LOINC® Code Information Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the result codes returned for this test or profile.
| Result ID | Reporting Name | LOINC Code |
|---|---|---|
| 80351 | Beta-2 Transferrin, BF | 13876-8 |
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