Pathology Handbook

Creutzfeldt-Jacob Disease Protein (Sendaway Test)

Department Head authorisation required (except Neurology patients).

CJD lab performs test Monday mornings.

Send to Lab before 4pm.

CSF should not be haemolysed or xanthochromic and must contain less than 500 RBC and <= 10 WBC per uL. Cell count must be performed on the tube to be sent (or a lower numbered tube). Send to Lab before 4pm.

CSF should be transferred (unspun) into a labelled screw top container using a sterile pipette as soon as possible after collection. Parafilm the lid. Initial label to indicate patient details have been checked.

Parafilm the lid

Freeze specimen at -20'C and store frozen. Record tube used and the date and time of freezing on the request form.

Transport in a biohazard bag and then place in a second biohazard bag.

Transport on dry ice, refer to CD_MI_0369_Serology_Sendaway_Procedure.doc for instructions.

Fill out 14-3-3 specimen data form and include biochem results and cell count.

Notify CJD Registry on (03) 8344 1949 before sending.

"Specimen Data Sheet" and general instructions can be found here--

http://anjcdr.path.unimelb.edu.au/protocols/14-3-3.html

Send to Lab before 4pm.

Notes:

(i)        The 14-3-3 protein is a non-specific marker of central nervous system neuronal injury or death. Based on international experience in carefully selected patient, a positive result has approximately 90% sensitivity and specificity for sporadic CJD. “False” positives are frequently recognised in encephalitis (especially Herpes Simplex) and recent cerebral infarcts.

(ii)   If the sample is haemorrhagic, a false positive result is likely. It is recommended that a repeat sample is submitted after 10 to 14 days.