Reactive increase of cerebrospinal fluid white blood cell count after lumbar puncture: Fact or fiction?

被引:3
|
作者
Neumann, Bernhard [1 ]
Steinberg, Tim [1 ]
Lee, De-Hyung [1 ]
Kress, Johanna [1 ]
Kufner, Marco [1 ]
Schlachetzki, Felix [1 ]
Weinfurtner, Georg [1 ]
Linker, Ralf [1 ]
Angstwurm, Klemens [1 ]
机构
[1] Univ Regensburg, Dept Neurol, Univ Str 84, D-93053 Regensburg, Germany
关键词
Cerebrospinal fluid; Lumbar puncture complication; Reactive pleocytosis;
D O I
10.1016/j.jns.2020.116876
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Lumbar puncture (LP) is commonly used in the diagnostic workup of neurological patients, often to exclude inflammatory diseases of the central nervous system. In clinical practice, an increase of white blood cell count (WBC) in the cerebrospinal fluid (CSF) after a LP is often assumed as reactive to the first puncture. Scientific evidence of this hypothesis, however, is lacking. Retrospective review of laboratory parameters was done by analyzing CSF of patients who had at least two LPs between 2012 and 2016 in a single center. Inclusion criteria were a normal CSF WBC in the first LP as well as absence of any underlying disease typically associated with increased CSF WBC. A total of 176 patients (age 57.0 +/- 17.6) with 260 serial LPs were included. No significant effect on the CSF WBC (1.2 +/- 1.1 vs 1.4 +/- 1.4/mu l, p = .17), lactat and protein level between consecutive punctures was found after a second LP. In the subgroup of 104 patients who had two LPs within ten days, only one (0.96%) showed a mild abnormal CSF WBC (9 leukocytes/mu l) in the second LP. A raise of CSF WBC after LP is rare and not commonly found; therefore, it should lead to careful exclusion of other, especially inflammatory diseases. The needle size is important to minimize the trauma during LP and seems to have an influence on the rate of reactive increase of CSF WBC after LP.
引用
收藏
页数:3
相关论文
共 50 条
  • [1] Interpretation of Cerebrospinal Fluid White Blood Cell Counts in Young Infants With a Traumatic Lumbar Puncture
    Lyons, Todd W.
    Cruz, Andrea T.
    Freedman, Stephen B.
    Neuman, Mark I.
    Balamuth, Fran
    Mistry, Rakesh D.
    Mahajan, Prashant
    Aronson, Paul L.
    Thomson, Joanna E.
    Pruitt, Christopher M.
    Shah, Samir S.
    Nigrovic, Lise E.
    [J]. ANNALS OF EMERGENCY MEDICINE, 2017, 69 (05) : 622 - 631
  • [2] Traumatic Lumbar Punctures in Neonates Test Performance of the Cerebrospinal Fluid White Blood Cell Count
    Greenberg, Rachel G.
    Smith, P. Brian
    Cotten, C. Michael
    Moody, M. Anthony
    Clark, Reese H.
    Benjamin, Daniel K., Jr.
    [J]. PEDIATRIC INFECTIOUS DISEASE JOURNAL, 2008, 27 (12) : 1047 - 1051
  • [3] The usefulness of cerebrospinal fluid white blood cell count in neurosyphilis
    Frater, John L.
    [J]. EUROPEAN NEUROLOGY, 2023, 86 (06) : 404 - 406
  • [4] Interpretation of white blood cell counts in the cerebrospinal fluid of neonates with traumatic lumbar puncture: a retrospective cohort study
    Gema García-De la Rosa
    Silvia De las Heras-Flórez
    Jorge Rodríguez-Afonso
    Mercedes Carretero-Pérez
    [J]. BMC Pediatrics, 22
  • [5] Interpretation of white blood cell counts in the cerebrospinal fluid of neonates with traumatic lumbar puncture: a retrospective cohort study
    Garcia-De la Rosa, Gema
    De las Heras-Florez, Silvia
    Rodriguez-Afonso, Jorge
    Carretero-Perez, Mercedes
    [J]. BMC PEDIATRICS, 2022, 22 (01)
  • [6] Epidural Cerebrospinal Fluid Collection After Lumbar Puncture
    Aronson, Paul L.
    Zonfrillo, Mark R.
    [J]. PEDIATRIC EMERGENCY CARE, 2009, 25 (07) : 467 - 468
  • [7] CEREBROSPINAL-FLUID FISTULA AFTER LUMBAR PUNCTURE
    KAR, AM
    PRADHAN, S
    MITTAL, P
    [J]. BRITISH MEDICAL JOURNAL, 1987, 295 (6597): : 528 - 528
  • [8] On the danger of leakage of the cerebrospinal fluid after lumbar puncture
    Ingvar, S
    [J]. ACTA MEDICA SCANDINAVICA, 1923, 58 (01): : 67 - 101
  • [9] EFFECT ON THE WHITE CELL COUNT OF CONTAMINATING CEREBROSPINAL-FLUID WITH BLOOD
    OSBORNE, JP
    PIZER, B
    [J]. ARCHIVES OF DISEASE IN CHILDHOOD, 1981, 56 (05) : 400 - 401
  • [10] AN IMPROVED TECHNIC FOR THE COLLECTION OF CEREBROSPINAL FLUID AFTER LUMBAR PUNCTURE
    SCHWEMLEIN, GX
    KENDELL, HW
    CRAIG, RM
    [J]. JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1945, 127 (16): : 1051 - 1051