Neuron-Specific Enolase (NSE), Spinal Fluid

Casandra

Casandra Test Code MC17299Version 1 (DRAFT)

Performing Lab

Lab Mayo Clinic LabLab Test ID NSESFCPT Code 83520

Neuron-Specific Enolase (NSE), Spinal Fluid

Clinical Use

Use

The Neuron-Specific Enolase (NSE), Spinal Fluid test is used as an auxiliary diagnostic tool for Creutzfeldt-Jakob disease (CJD) and to detect small cell lung carcinoma metastasis to the central nervous system or leptomeninges. NSE is a gamma-homodimer isoenzyme found predominantly in neuronal and neuroendocrine tissues. Its concentration in cerebrospinal fluid (CSF) becomes elevated during rapid neuronal destruction, as frequently observed in progressive dementias such as CJD and in metastatic conditions involving the CNS. Therefore, NSE measurement helps in differentiating these conditions.

Special Instructions

It is critical to use the same assay method for serial follow-up due to variability in NSE values between different methods. False results can occur due to hemolysis or the presence of human anti-mouse antibodies (HAMA). This test is specifically developed by Mayo Clinic and is in line with CLIA requirements but not cleared or approved by the FDA. The test performs on Mondays through Saturdays, and results are typically available from 1 to 3 days after sample receipt.

Limitations

The diagnosis of CJD involves a combination of clinical history, examination, and tests, including EEG and MRI. NSE results need to be interpreted within the broader clinical context. Artifactual elevations can arise from hemolysis, interference by hemolytic anemia, hepatic failure, or end-stage kidney failure. Proton pump inhibitor treatments and certain neurological conditions may cause false positives. The test has limited prognostic value for coma patients.

Test Details

New York Approved