Pandy's test (or Pandy's reaction) is done on the CSF (cerebrospinal fluid) to detect the elevated levels of

protein Proteins are large biomolecules and macromolecules that comprise one or more long chains of amino acid residue (biochemistry), residues. Proteins perform a vast array of functions within organisms, including Enzyme catalysis, catalysing metab ...

s (mainly

globulins The globulins are a family of globular proteins that have higher molecular weights than albumins and are insoluble in pure water but dissolve in dilute salt solutions. Some globulins are produced in the liver, while others are made by the immun ...

). This test is named after the Hungarian

neurologist Neurology (from , "string, nerve" and the suffix -logia, "study of") is the branch of medicine dealing with the diagnosis and treatment of all categories of conditions and disease involving the nervous system, which comprises the brain, the ...

, Pándy Kálmán (1868–1945) who developed this test in the year 1910.

Principle

Proteins (

globulin The globulins are a family of globular proteins that have higher molecular weights than albumins and are insoluble in pure water but dissolve in dilute salt solutions. Some globulins are produced in the liver, while others are made by the immune ...

and

albumin Albumin is a family of globular proteins, the most common of which are the serum albumins. All of the proteins of the albumin family are water- soluble, moderately soluble in concentrated salt solutions, and experience heat denaturation. Alb ...

) are precipitated by a saturated solution of phenol in water. The reagent used is

phenol Phenol (also known as carbolic acid, phenolic acid, or benzenol) is an aromatic organic compound with the molecular formula . It is a white crystalline solid that is volatile and can catch fire. The molecule consists of a phenyl group () ...

(

carbolic acid Phenol (also known as carbolic acid, phenolic acid, or benzenol) is an aromatic organic compound with the molecular formula . It is a white crystalline solid that is volatile and can catch fire. The molecule consists of a phenyl group () bon ...

crystals dissolved in water) or, pyrogallic acid or,

cresol Cresols (also known as hydroxytoluene, toluenol, benzol or cresylic acid) are a group of aromatic organic compounds. They are widely-occurring phenols (sometimes called ''phenolics'') which may be either natural or manufactured. They are also c ...

, usually termed as Pandy's reagent or Pandy's solution.

Procedure

One drop of CSF sample (collected from the patient by lumbar puncture technique), is added to about 1ml of Pandy's solution. The turbid appearance signifies the presence of elevated levels of globulin protein in the CSF and is regarded as positive Pandy's reaction. The CSF from a normal adult shows no turbidity or precipitates and this is a negative Pandy's reaction.

Reactions and Results

Proteins in the cerebrospinal fluid, normally albumin and globulin are present in the ratio of 8 to 1. Increases in protein levels are of diagnostic value in neurological diseases. ''The normal CSF is clear and transparent fluid. The Pandy's reaction makes it translucent or opaque.''

Positive test

A positive test shows a bluish-white streak of precipitated proteins. The degree of turbidity depends on the amount of protein in the CSF. It can vary from faint turbidity (mild to moderate elevation in CSF proteins) to dense milky precipitate (high protein content in CSF). The positive Pandy's reaction may indicate one or more of the following pathological conditions: *

Diabetes mellitus Diabetes mellitus, commonly known as diabetes, is a group of common endocrine diseases characterized by sustained hyperglycemia, high blood sugar levels. Diabetes is due to either the pancreas not producing enough of the hormone insulin, or th ...

Brain tumor A brain tumor (sometimes referred to as brain cancer) occurs when a group of cells within the Human brain, brain turn cancerous and grow out of control, creating a mass. There are two main types of tumors: malignant (cancerous) tumors and benign ...

(

Meningioma Meningioma, also known as meningeal tumor, is typically a slow-growing tumor that forms from the meninges, the membranous layers surrounding the brain and spinal cord. Symptoms depend on the location and occur as a result of the tumor pressing ...

, Acoustic neuroma or,

Ependymoma An ependymoma is a tumor that arises from the ependyma, a tissue of the central nervous system. Usually, in pediatric cases the location is intracranial, while in adults it is spinal. The common location of intracranial ependymomas is the floor ...

) * Encapsulated

brain abscess The brain is an organ that serves as the center of the nervous system in all vertebrate and most invertebrate animals. It consists of nervous tissue and is typically located in the head ( cephalization), usually near organs for special sense ...

* Spinal cord tumor *

Multiple sclerosis Multiple sclerosis (MS) is an autoimmune disease resulting in damage to myelinthe insulating covers of nerve cellsin the brain and spinal cord. As a demyelinating disease, MS disrupts the nervous system's ability to Action potential, transmit ...

* Acute purulent

Meningitis Meningitis is acute or chronic inflammation of the protective membranes covering the brain and spinal cord, collectively called the meninges. The most common symptoms are fever, intense headache, vomiting and neck stiffness and occasion ...

* Granulomatous Meningitis * Carcinomatous Meningitis *

Syphilis Syphilis () is a sexually transmitted infection caused by the bacterium ''Treponema pallidum'' subspecies ''pallidum''. The signs and symptoms depend on the stage it presents: primary, secondary, latent syphilis, latent or tertiary. The prim ...

(protein may be normal if longstanding) *

Guillain–Barré syndrome Guillain–Barré syndrome (GBS) is a rapid-onset Paralysis, muscle weakness caused by the immune system damaging the peripheral nervous system. Typically, both sides of the body are involved, and the initial symptoms are changes in sensation ...

nfectious polyneuritis">polyneuritis.html" ;"title="nfectious polyneuritis">nfectious polyneuritis(Protein rises after 5–7 days) * Cushing's disease * Connective tissue disease * Uremia * Myxedema * Cerebral hemorrhage Normally, cerebrospinal fluid in adults contains about 15–45 mg/dL of protein, with albumin making up the bulk compared to globulins at roughly an 8:1 ratio. When Pandy’s reagent is added, a slight haze typically reflects protein levels between 50 and 100 mg/dL, whereas a thick, milk‑like cloud points to concentrations exceeding 100 mg/dL. Although this simple, low‑cost assay remains useful in laboratories with limited resources, it cannot distinguish individual protein types and may miss early Guillain‑Barré syndrome or chronic syphilis, so modern lab methods like electrophoresis or immunoassays are recommended for precise measurements.

Negative test

No cloudy turbidity observed. The CSF sample is normal i.e. with normal protein contents. ''Please note that the normal CSF protein is also obtained in several pathological conditions like viral CNS infections, brainstem glioma,

ischemic Ischemia or ischaemia is a restriction in blood supply to any tissue, muscle group, or organ of the body, causing a shortage of oxygen that is needed for cellular metabolism (to keep tissue alive). Ischemia is generally caused by problems ...

cerebrovascular accident.''

References

# Merriam-Webster's Free Medical Dictionary. http://www.merriam-webster.com/medical/pandy%27s+test?show=0&t=1288164619 # Biology-Online Dictionary. http://www.biology-online.org/dictionary/Pandys_reaction # Kooiker and Roberts (1998) Procedures in ER # Ravel (1995) Lab Medicine, Mosby # Tunkel and Mandell (2000) Infectious Disease # {{cite journal , pmid = 14524396 , volume=68 , title=Cerebrospinal fluid analysis , date=September 2003 , vauthors=Seehusen DA, Reeves MM, Fomin DA , journal=Am Fam Physician , issue=6 , pages=1103–8

External links

Diagnostic test A medical test is a medical procedure performed to detect, diagnose, or monitor diseases, disease processes, susceptibility, or to determine a course of treatment. Medical tests such as, physical and visual exams, diagnostic imaging, genetic ...

CSF tests