Cerebrospinal fluid adenosine deaminase activity: A complimentary tool in the early diagnosis of tuberculous meningitis

被引：4
作者：
Kashyap R.S. [1 ]
Kainthla R.P. [1 ]
Mudaliar A.V. [1 ]
Purohit H.J. [2 ]
Taori G.M. [1 ]
Daginawala H.F. [1 ]
机构：
[1] Biochemistry Research Laboratory, Central India Institute of Medical Sciences, Nagpur-440010
[2] Environmental Genomics Unit, NEERI, Nagpur-440020, Nehru Marg
来源：
Cerebrospinal Fluid Research | / 3卷 / 1期
关键词：
Meningitis; Tuberculous Meningitis; Viral Meningitis; Extra Pulmonary Tuberculosis; Meningeal Irritation;
D O I：
10.1186/1743-8454-3-5
中图分类号：
学科分类号：
摘要：
Background: Tuberculous meningitis (TBM) is the commonest form of neurotuberculosis caused by Mycobacterium tuberculosis bacilli (MTB). The diagnosis of TBM is often difficult. A reliable, cost-effective and rapid diagnostic test, which can be performed in any standard pathology laboratory, could be of help in the diagnosis of TBM. In the present study we measured the adenosine deaminase (ADA) activity in cerebrospinal fluid (CSF) of TBM and non-TBM patients. Method: ADA activity in CSF was determined according to a method based on the Berthlot reaction, which is the formation of a colored indophenol complex from ammonia liberated from adenosine, and quantified spectrophotometrically. Results: The CSF ADA activity from TBM patients was compared with CSF ADA from non-TBM infectious meningitis patients, and from patients with non-infectious neurological disorders. The mean CSF ADA activity was found to be significantly higher in CSF of TBM patients, 14.31 ± 3.87 (2.99-26.94), mean ± SD with range, than in the CSF from non-TBM infectious meningitis, 9.25 ± 2.14 (4.99-13.96) and from the non-infectious neurological disorders group, 2.71 ± 1.96 (0.007.68), P < 0.0001 for both comparisons. A cut-off value of 11.39 U/L/min for the TBM patients was calculated from the mean + SD of the non-TBM patients. The ADA test gave a sensitivity of 82% and a specificity of 83% for infectious TBM when this cut-off value was used. Conclusion: This study demonstrated that ADA activity in the CSF of TBM patients, using a cut-off value 11.39 U/L/min, can be useful for the early differential diagnosis of TBM. This test can be performed in any pathology laboratory where more sophisticated methods are not available. © 2006 Kashyap et al; licensee BioMed Central Ltd.
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