Pragmatic and evidence-based approach to paediatric cerebrospinal fluid reference limits for white cell count and concentrations of total protein and glucose

Background It is often impractical for each laboratory to establish its own paediatric reference intervals. This is particularly true for specimen types collected using invasive procedures, for example, cerebrospinal fluid (CSF). Methods Published CSF reference intervals for white cell count, and concentrations of total protein and glucose were reviewed by stakeholders in a paediatric hospital. Consensus reference intervals for the three CSF parameters were then subjected to verification using guidelines from the Clinical Laboratory Standards Institute and residual CSF specimens. Results Consensus paediatric reference intervals adapted from published studies with minor modifications were locally verified as follows. White cell count (x10 6 cells/L): 0–20 ( 2 months). Total protein (g/L): 0.3–1.2 ( 3 months). Glucose (mmol/L): 2.0–5.6 (