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From the Department of Neurology (Drs. Lemstra, van Meegen, Vreyling, Meijerink, Bulk, Baas, and van Gool), Academic Medical Center, University of Amsterdam; and the Department of Pathology (Dr. Jansen), University Medical Center Utrecht, the Netherlands.
Address correspondence and reprint requests to Dr. A.W. Lemstra, Department of Neurology, Academic Medical Center Amsterdam, the Netherlands; e-mail: a.w.lemstra{at}amc.uva.nl
OBJECTIVE: To study the sensitivity and specificity of 14-3-3 testing in a prospective series of patients suspected of having Creutzfeldt-Jakob disease (CJD).
BACKGROUND: The 14-3-3 protein immunoassay on CSF has favorable test characteristics as a premortem diagnostic tool in CJD. However, the 14-3-3 protein is a normal cellular protein expressed in various tissues, and its presence in CSF reflects extensive destruction of brain tissue as in CJD, but also in ischemic stroke and meningoencephalitis.
METHODS: 14-3-3 was tested in the CSF of a prospective series of 110 consecutive patients suspected of having CJD.
RESULTS: The sensitivity was 97% and the specificity was 87% in this series. False-positive results were mainly caused by stroke and meningoencephalitis.
CONCLUSION: The 14-3-3 protein is a highly sensitive and specific marker for CJD when used in the appropriate clinical context.
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