Total Protein Content of Cerebrospinal Fluid in Multiple Myeloma

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Abstract
Detn. of the total spinal fluid protein was performed in 21 patients with multiple myeloma. Total serum protein estimations on blood drawn at the same time as the lumbar puncture were done in 20 of the patients. Excluding the 3 patients with manometric block, 10 patients had spinal fluid protein values of 50 mg. or more per 100 cc. and 8 were below 50 mg. per 100 cc. No relationship could be demonstrated between the total serum and total spinal fluid protein concns. No relationship could be demonstrated between the presence or absence of Bence-Jones protein in the urine and the total spinal fluid concns. The reason for the elevation in the protein content of the cerebrospinal fluid in multiple myeloma is not known. Possibly it is due to an alteration in the permeability of the choroid plexus, or perhaps it is due to an increase in production, especially of globulin, by the central nervous tissues, with subseauent passage into the spinal fluid. There was no correlation between an elevated total protein in the cerebrospinal fluid and signs or symptoms of involvement of the nervous system. Hence, an elevated total protein in the cerebrospinal fluid does not necessarily signify the presence of neurologic complications; in such instances the increase of protein in the spinal fluid is probably a general manifestation of the disease.

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