Diagnosis of Creutzfeldt-Jakob disease by measurement of S100 protein in serum

BMJ 1998;317:472 ( 15 August )

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Diagnosis of Creutzfeldt-Jakob disease by measurement of S100 protein in serum

Appropriate study populations must be used

Tonsil biopsy helps diagnose new variant Creutzfeldt-Jakob disease

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Appropriate study populations must be used

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EDITOR $---$ Otto et al describe significant differences in the serum concentrations of S100 protein in patients with and withoutCreutzfeldt-Jakob disease.¹ The population of patients studiedis, however, not appropriate for assessing the usefulness of measuringserum concentrations of S100 protein as a diagnostic test, andOtto et al's calculations of positive and negative predictivevalues of the test are invalid as they fail to take into considerationthe prevalence of Creutzfeldt-Jakob disease as a cause ofdementia.

Patients with clinically evident disease do not need a diagnostic test. It is not informative to evaluate the potential ofa blood test to distinguish those with clinically definite Creutzfeldt-Jakobdisease from those without the disease on clinical grounds. Thetest is useful only if it helps to predict the likelihood of thedisease in a population that does not meet the criteria for probableCreutzfeldt-Jakob disease, which is therefore the . . . [Full text of this article]

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