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BioMed Research International
Volume 2013 (2013), Article ID 745943, 8 pages
Research Article

Coefficient of Energy Balance: Effective Tool for Early Differential Diagnosis of CNS Diseases

1Department of Clinical Biochemistry, Thomayer’s Hospital, Vídeňská 800, 140 59 Prague, Czech Republic
2Laboratory for CSF and Neuroimmunology, Topelex Ltd, Central Military Hospital Complex, U Vojenské nemocnice 1200, 162 00 Prague, Czech Republic
3Department of Neurology, 3rd Medical Faculty, Charles University, Šrobárova 50, 100 34 Prague, Czech Republic
4Statistical Unit, Institute for Clinical and Experimental Medicine, Vídeňská 1958/9, 140 21 Prague, Czech Republic

Received 13 February 2013; Revised 23 April 2013; Accepted 21 May 2013

Academic Editor: Shih-Bin Su

Copyright © 2013 Klára Bořecká et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Urgent examination of cerebrospinal fluid (CSF) provides immediate important information about the character of central nervous system (CNS) impairment. Although this examination includes energy parameters such as glucose and lactate concentrations, it does not commonly use Coefficient of Energy Balance (CEB). In this study, we focused on CEB because it enables more exact assessment of actual energy state in the CSF compartment than glucose and lactate alone. CEB informs about the actual functioning condition of present cells, and it does not require any other analysis or costs. Using Kruskal-Wallis ANOVA, we examined a large CSF sample ( ) and we compared CEB values among groups with different cytological syndromes. We found a statistically significant difference of CEB between the group with granulocyte pleocytosis and the control group. These results indicate a high degree of anaerobic metabolism caused by the oxidative burst of neutrophils. Similarly, we found a statistically significant difference of CEB between the control group and groups with tumorous oligocytosis plus pleocytosis and monocyte pleocytosis. This difference can be attributed to the oxidative burst of macrophages. Our findings suggest that CEB combined with CSF cytology has a great importance for diagnosis, differential diagnosis, and early therapy of CNS diseases.