Cerebrospinal fluid adenosine deaminase activity for the diagnosis of tuberculous meningitis

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Author:
SUN Qin(Department of Tuberculosis,Shanghai Pulmonary Hospital Affiliated to Tongji University,Shanghai 200433,China)
SHA Wei(Department of Tuberculosis,Shanghai Pulmonary Hospital Affiliated to Tongji University,Shanghai 200433,China)
XIAO He-ping(Department of Tuberculosis,Shanghai Pulmonary Hospital Affiliated to Tongji University,Shanghai 200433,China)
TIAN Qing()
ZHU Hong()
Journal Title:
CHINESE JOURNAL OF CLINICAL INFECTIOUS DISEASES
Issue:
Volume 03, Issue 05, 2010
DOI:
10.3760/cma.j.issn.1674-2397.2010.05.003
Key Word:
Adenosine deaminase;Meningitis;Tuberculosis;Cerebrospinal fluid

Abstract: Objective To evaluate cerebrospinal fluid adenosine deaminase(CSF-ADA)activity in the diagnosis of tuberculous meningitis(TMB), and to observe its dynamic changes. Methods A total of 160 patients were included and were divided into two groups: 76 cases of TBM and 84 cases of non-TBM.Among the cases of non-TBM, there were 36 cases of bacterial meningitis, 30 cases of viral meningitis and 18 cases of cryptocoocal meningitis. All the patients were measured with their CSF-ADA activity by Enzymecoupled assay(Trinder method)and 47 patients of TBM were measured again after 2 weeks' and 6 weeks'antitubercular therapy. Results were expressed as(-x)± s. Mann-Whitney U test and paired-samples t test were used. Results CSF-ADA activity in TBM group was(12.9 ±6.4)U/L, while that in the non-TBM group was(6.0 ± 4.1)U/L, the difference was of statistical significance(U = 7.860, P < 0.05). With the cutoff value of 9 U/L, the sensitivity and specificity to differentiate TBM from non-TBM was 84.21% and 83. 33%, respectively. CSF-ADA activity decreased in TBM patients after antitubercular treatment.Conclusions CSF-ADA activity can be an effective laboratory marker for early differential diagnosis of TMB with the cut-off value of 9 U/L. Dynamic changes of CSF-ADA activity may be a indicator for the effect of antitubercular treatment.

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