Diagnostic Importance of Cerebrospinal Fluid Adenosine Deaminase Levels in Tuberculous Meningitis

Abstract

Introduction: Estimation of Cerebrospinal Fluid (CSF) Adenosine Deaminase (ADA) is used for early diagnosis of Tuberculous Meningitis (TBM) and has got importance in differentiating TBM from bacterial and viral types of meningitis. Hence, estimation of ADA in CSF can be carried out in all clinically suspected meningitis patients, especially in developing countries like India with high prevalence of Tuberculosis (TB). Aim: To evaluate CSF ADA as a diagnostic test for TBM. Materials and Methods: The prospective study was done on 80 cases admitted with meningitis in Government General Hospital Kakinada, Andhra Pradesh, India, in a period of eight months during August 2018 to March 2019. In all the subjects the concentrations of CSF ADA, Glucose, Total proteins, Calcium, and Phosphorus were assayed. Results: The results shows that the mean values of CSF ADA in TBM were significantly increased (15.13±12.2) when compared with other types of meningitis due to stimulation of T-cells by Mycobacterium antigens. Mean values of CSF glucose were significantly decreased in bacterial and TBM. Mean values of CSF total proteins were increased in all three types. Conclusion: Therefore, this study suggests the need for routine measurement of CSF ADA in the diagnosis of TBM and thus helps in early detection of TBM which warrants timely intervention leading to lowered morbidity and mortality.

Keywords

• bacterial meningitis
• t-cells
• viral meningitis