2nd order laboratory parameters – depending on the results of the history, physical examination, and obligatory laboratory parameters – for differential diagnostic clarification in disorders of consciousness or brain tumors* .
- Small blood count
- Inflammatory parameters – CRP (C-reactive protein) or ESR (erythrocyte sedimentation rate).
- Urine status (rapid test for: pH, leukocytes, nitrite, protein, glucose, ketone, urobilinogen, bilirubin, blood).
- Electrolytes – sodium, potassium, chloride, calcium.
- Fasting glucose (fasting blood glucose).
- Blood gas analysis (BGA)
- Thyroid parameters – TSH
- Liver parameters – alanine aminotransferase (ALT, GPT), aspartate aminotransferase (AST, GOT), glutamate dehydrogenase (GLDH) and gamma-glutamyl transferase (gamma-GT, GGT), alkaline phosphatase, bilirubin.
- Renal parameters – urea, creatinine, cystatin C or creatinine clearance, if necessary.
- Coagulation parameters – PTT, Quick
- Blood cultures, smears from drains, etc.
- Toxicological examinations – in case of suspected intoxications.
- CSF puncture (collection of cerebrospinal fluid by puncture of the spinal canal) for CSF diagnosis – in cases of suspected CNS tumors/central nervous system (e.g. gliomas, ependymoma, medulloblastoma).
- Molecular markers of glioma:
- Isocitrate dehydrogenase 1 and/or -2 (IDH-1/-2).
- Characteristic of low-grade or anaplastic gliomas.
- New-onset glioblastomas are usually IDH-1 wild-type (WT); a (rare) IDH-1 mutation in glioblastoma is suggestive of arising from a lower-grade precursor.
- Codeletion of chromosomal parts 1p and 19q.
- ≡ IDH-1 mutant tumors the oligodendroglial origin of the tumors. Astrocytomas are characterized by a lack of codeletion 1p/19q.
- Mutation in histone 3 (H3 K27M).
- ≡ diffuse midline gliomas, most of which have an unfavorable prognosis.
- Isocitrate dehydrogenase 1 and/or -2 (IDH-1/-2).
- MGMT (methylguanine-DNA methyltransferase; rs16906252)* – biomarker for glioblastoma therapy.
