B2 TRANSFERRION PROTEIN

Beta-2-transferrin, a protein exclusively generated through neuraminidase activity in the brain, stands as a distinctive marker confined to cerebrospinal fluid (CSF) and perilymph. Its absence in other bodily secretions elevates its diagnostic significance in identifying CSF leaks. In a cohort of 25 patients presenting with suspected CSF rhinorrhoea, immuno-fixation electrophoresis was employed to ascertain the presence of beta-2-transferrin. Of these patients, 16 exhibited positive results, and subsequent surgical intervention confirmed dural defects and CSF leaks in 13 cases. Remarkably, spontaneous cessation of rhinorrhoea occurred in three patients. Contrastingly, among the nine individuals lacking beta-2-transferrin in nasal fluids, two underwent craniotomy without evidence of CSF leak or dural defect. Notably, two out of eight patients, despite having normal computerized coronal tomography (CT), manifested CSF leaks. CT cisternography, conducted in 17 patients, revealed leaks in seven beta-2-transferrin-positive cases, while four remained unconfirmed. Importantly, none of the beta-2-transferrin-negative patients exhibited leaks in CT cisternography, underscoring the protein’s value as a sensitive diagnostic tool. Consequently, patients suspected of CSF leaks without beta-2-transferrin in nasal discharge can potentially circumvent unnecessary invasive investigations.