Dear Colleagues,
As Chairman of the Group who produced the UK Guidelines for CSF
Spectrophotometry, I would like to make the following observations.
We acknowledge the potential of the methods for measurement of CSF bilirubin
basd on modifications of colourimetric, diazo methods used for serum
bilirubin assay. The original paper raised a number of questions about the
validity of such methods, not least that of the reference range which begins
at what we would normally consider to be the upper limity as defined by
absorbance criteria. The great strength of the spectrophotometric assay is
that the reference range has been defined clinically in a large group of
patients. Until such time as the direct method has been compared against
spectrophotometry in a sufficiently large cohort of patients to include
sufficient positives (rate about 2-3 per 100), spectrophotometry remains the
method of choice. UK members (at least) would also need to be aware of
whether use in this way was in line with CE marking.
Robert Beetham
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