I discuss issues pertaining to the practice of neuropathology -- including nervous system tumors, neuroanatomy, neurodegenerative disease, muscle and nerve disorders, ophthalmologic pathology, neuro trivia, neuropathology gossip, job listings and anything else that might be of interest to a blue-collar neuropathologist.
Monday, December 3, 2007
14-3-3 protein
A clinician at my hospital ordered a CSF 14-3-3 protein on a lethargic elderly woman with a urinary tract infection. What a waste! The problem with clinicians ordering this test unnecessarily is that it obligates the lab technicians to decontaminate equipment to protect against the possibility of prion contamination. It's an inefficient use of resources for a test that is very non-specific. The patient in question had none of the characteristic clincal signs, nor did she have an EEG done to gathter evidence that she may have CJD. Ordering that test in this patient is just bad medicine.
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1 comment:
Agree completely. I don't know why 14-3-3 testing would force a decontamination of equipment. 14-3-3 is not specific for CJD. She could have been lethargic from a stroke or encephalitis, which would also elevate 14-3-3 as well, and then you'd all think she had CJD!
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