CEREBROSPINAL FLUID GAMMA GLOBULIN CONCENTRATION IN MYXEDEMA*

Abstract

The concentrations of gamma globulin and total protein in the cerebrospinal fluid of normal and myxedematous subjects were determined by a modification of the tyrosine equivalence method. In 10 of 14 patients with myxedema, there was an elevation of the gamma globulin/total protein ratio not attributable to serum hypergammaglobulinemia. In 4 of these cases, an elevated concentration of spinal fluid gamma globulin was present despite a normal level of total cerebrospinal fluid protein. These data cast doubt on the hypothesis that permeability of the blood-cerebrospinal fluid barrier to serum proteins accounts for the elevation of spinal fluid protein in myxedema. THE frequent elevation of the cerebrospinal fluid protein level in patients with myxedema was documented by Thompson and his coworkers in 1928 (1, 2). Recently this phenomenon was restudied by Bronsky et al. (3), who confirmed the original findings and presented additional data on the electrophoretic partition of cerebrospinal fluid proteins. These investigators described an increase in the concentration of spinal fluid gamma globulin proportional to the increase in concentration of total protein, and concluded that it could be attributed to loss of integrity of the blood-cerebrospinal fluid barrier.