Adenosine Deaminase Levels in CSF of Tuberculous Meningitis Patients.

Content Provider	Europe PMC
Author	Gupta, Bharat Kumar Bharat, Anchit Debapriya, Bandyopadhyay Baruah, Haren
Copyright Year	2010
Abstract	BackgroundTuberculosis kills five lakh patients in India every year, out of which 7-12 % are with meningeal involvement. Delay in its diagnosis and in initiation of treatment results in poor prognosis and sequlae in up to 25% of cases. The aim of the present study is to look for a simple, rapid, cost effective, non-invasive and fairly specific test in differentiating tubercular etiology from other causes.MethodsForty patients between the age of 6 - 24 months attending hospital with symptoms and signs of meningitis were selected and divided into two groups: tubercular and non-tubercular, depending upon the accepted criteria. CSF was drawn and ADA estimated.ResultsOut of 19 tubercular patients, 18 had CSF ADA at or above the cutoff value while one had below. Out of 21 non-tuberculous patients, two had ADA levels at or above the cutoff value while 19 had below this value. Results of our study indicate that ADA level estimation in CSF is not only of considerable value in the diagnosis of TBM, CSF ADA level 10 U/L as a cutoff value exhibited 94.73% sensitivity and 90.47% specificity in differentiating tuberculous from non-tuberculous meningitis; it also has 90.00% positive predictive value and 95.00% negative predictive value.ConclusionsIt can be concluded that ADA estimation in CSF is not only simple, inexpensive and rapid but also fairly specific method for making a diagnosis of tuberculous etiology in TBM, especially when there is a dilemma of differentiating the tuberculous etiology from non-tuberculous ones. For this reason ADA estimation in TBM may find a place as a routine investigation.KeywordsCerebrospinal fluid; Adenosine deaminase; Tuberculous meningitis
ISSN	19183003
Journal	Journal of Clinical Medicine Research
Volume Number	2
PubMed Central reference number	PMC3104661
Issue Number	5
PubMed reference number	21629544
e-ISSN	19183011
DOI	10.4021/jocmr429w
Language	English
Publisher	Elmer Press
Publisher Date	2010-10-01
Access Restriction	Open
Rights License	This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Copyright © 2010, Gupta et al.
Content Type	Text
Resource Type	Article
Subject	Medicine