Test Catalog

Test Id : TPSF

Protein, Total, Spinal Fluid

Useful For
Suggests clinical disorders or settings where the test may be helpful

Detecting disruptions of the blood-brain barrier or intrathecal synthesis of immunoglobulins

Method Name
A short description of the method used to perform the test

Reflectance Spectrophotometry

NY State Available
Indicates the status of NY State approval and if the test is orderable for NY State clients.


Reporting Name
Lists a shorter or abbreviated version of the Published Name for a test

Protein, Total, CSF

Lists additional common names for a test, as an aid in searching

Protein, Total, CSF

Specimen Type
Describes the specimen type validated for testing


Specimen Required
Defines the optimal specimen required to perform the test and the preferred volume to complete testing

Container/Tube: Sterile vial

Specimen Volume: 1 mL

Collection Instructions: Centrifuge specimen to remove any cellular material.


If not ordering electronically, complete, print, and send a Renal Diagnostics Test Request (T830) with the specimen.

Specimen Minimum Volume
Defines the amount of sample necessary to provide a clinically relevant result as determined by the Testing Laboratory

0.25 mL

Reject Due To
Identifies specimen types and conditions that may cause the specimen to be rejected

All specimens will be evaluated at Mayo Clinic Laboratories for test suitability.

Specimen Stability Information
Provides a description of the temperatures required to transport a specimen to the performing laboratory, alternate acceptable temperatures are also included

Specimen Type Temperature Time Special Container
CSF Refrigerated (preferred) 72 hours
Frozen 180 days

Useful For
Suggests clinical disorders or settings where the test may be helpful

Detecting disruptions of the blood-brain barrier or intrathecal synthesis of immunoglobulins

Clinical Information
Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test

Cerebrospinal fluid (CSF) proteins are those that remain in CSF following the ultrafiltration of plasma through the choroidal capillary wall. Some proteins that are unique to CSF are synthesized in the central nervous system. In general, diseases that interrupt the integrity of the capillary endothelial barrier lead to an increase in the total CSF protein.


CSF protein is generally increased in all types of meningitis, cerebral infarction, brain abscess, meningovascular syphilis, subarachnoid hemorrhage, some brain tumors, trauma to the brain, some cases of multiple sclerosis, encephalomyelitis, and degenerative neurologic diseases. A decreased CSF protein may occur in water intoxication, CSF leak (CSF rhinorrhea or otorrhea), and hyperthyroidism.

Reference Values
Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.

> or =12 months: 0-35 mg/dL

Reference values have not been established for patients that are <12 months of age.

Provides information to assist in interpretation of the test results

Striking elevations of cerebrospinal fluid (CSF) total protein are noted in bacterial meningitis; smaller elevations occur in the other inflammatory diseases and with tumor or hemorrhage. The effect of any of these conditions is that the proportions of specific proteins in CSF increasingly resemble serum.


In order to assess increased permeability or increased intrathecal production of proteins, simultaneous serum specimen and CSF specimens should be taken.

Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances

Increased cerebrospinal fluid (CSF) total protein is sensitive, but not specific, for detecting disruptions of the blood-brain barrier or intrathecal synthesis of immunoglobulins.


The presence of hemoglobin in CSF will cause an increase in measured total protein by this method. Internal validation studies have been conducted to estimate the contribution of hemolysis to the measured total protein concentration, and are appended to the result as a comment in these situations. Results should be interpreted with caution as hemolysis may be present due to traumatic lumbar puncture or due to a CNS hemorrhagic process.


Specimens should be collected prior to the intrathecal administration of contrast media. Significant positive bias can occur when CSF contains contrast media. Examples of contrast media include Iopamidol, Iohexol, and Metrizamide.


Blood in the CSF specimen invalidates the protein value.

Clinical Reference
Recommendations for in-depth reading of a clinical nature

1. Tietz Textbook of Clinical Chemistry. Fourth edition. Edited by CA Burtis, ER Ashwood, DE Bruns. Philadelphia, WB Saunders Company, 2006

2. Killingsworth LM: Clinical applications of protein determinations in biological fluids other than blood. Clin Chem 1982;28:1093-1103

3. Henry’s Clinical Diagnosis and Management by Laboratory Methods. Cerebrospinal, synovial, and serous body fluids.  Edited by McPherson and Pincus. Philadelphia, WB Saunders Co, 2007, 431-435

Method Description
Describes how the test is performed and provides a method-specific reference

Patient sample is deposited on the slide and is evenly distributed by the spreading layer. Protein in the sample forms a complex with cupric ion and results in the dissociation of the cupric ion from the copper-azo dye complex. The decrease of the copper-azo dye complex is measured by the reflectance spectrophotometry and is proportional to the concentration of proteins in the sample.(Package insert: Vitros Chemistry Products Instructions for Use-PROT Slides, Ortho-Clinical Diagnostics, Inc. Rochester, NY 14626)

PDF Report
Indicates whether the report includes an additional document with charts, images or other enriched information


Day(s) Performed
Outlines the days the test is performed. This field reflects the day that the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time before the test is performed. Some tests are listed as continuously performed, which means that assays are performed multiple times during the day.

Monday through Sunday

Report Available
The interval of time (receipt of sample at Mayo Clinic Laboratories to results available) taking into account standard setup days and weekends. The first day is the time that it typically takes for a result to be available. The last day is the time it might take, accounting for any necessary repeated testing.

Same day/1 to 2 days

Specimen Retention Time
Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded

7 days

Performing Laboratory Location
Indicates the location of the laboratory that performs the test


Several factors determine the fee charged to perform a test. Contact your U.S. or International Regional Manager for information about establishing a fee schedule or to learn more about resources to optimize test selection.

  • Authorized users can sign in to Test Prices for detailed fee information.
  • Clients without access to Test Prices can contact Customer Service 24 hours a day, seven days a week.
  • Prospective clients should contact their Regional Manager. For assistance, contact Customer Service.

Test Classification
Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR) product.

This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.

CPT Code Information
Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Clinic Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.

CPT codes are provided by the performing laboratory.


LOINC® Information
Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the order and results codes of this test. LOINC values are provided by the performing laboratory.

Test Id Test Order Name Order LOINC Value
TPSF Protein, Total, CSF 2880-3
Result Id Test Result Name Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
TPSF Protein, Total, CSF 2880-3

Test Setup Resources

Setup Files
Test setup information contains test file definition details to support order and result interfacing between Mayo Clinic Laboratories and your Laboratory Information System.

Excel | Pdf

Sample Reports
Normal and Abnormal sample reports are provided as references for report appearance.

Normal Reports | Abnormal Reports

SI Sample Reports
International System (SI) of Unit reports are provided for a limited number of tests. These reports are intended for international account use and are only available through MayoLINK accounts that have been defined to receive them.

SI Normal Reports | SI Abnormal Reports