Cerebrospinal Fluid Adenosine Deaminase Activity: A Valid Ancillary Test for Tubercular Meningitis
Journal Title: International Journal of Clinical Biochemistry and Research - Year 2016, Vol 3, Issue 2
Abstract
Background: Tuberculosis affects 1.80 million persons every year with 3.70 lakh annual deaths, ~ 10% of which are of meningeal involvement. Diagnosis of Tubercular meningitis is difficult with often under or over diagnosis. Delay in diagnosis and initiation of treatment results in poor prognosis and sequel in up to 25% of cases. Cerebrospinal fluid (CSF) Adenosine deaminase (ADA) is a simple, reliable, cost effective and rapid diagnostic test that can even be done in small clinical laboratory set up. We evaluated CSF-ADA as an ancillary test for tubercular meningitis (TBM). Materials and Methods: Total 118 CSF samples were analyzed in this study under four different groups viz. TBM (n= 30), pyogenic meningitis (PM, n=24), aseptic meningitis (AM, n=20) and Controls (no meningeal involvement, n=44). Diagnosis of meningitis was done by clinicians on the basis of presence of signs of meningeal irritation and cytological and biochemical examination of CSF. CSF-ADA was estimated by method based on Berthelot reaction, which is the formation of a colored indophenol complex from ammonia liberated from adenosine, and quantified colorimetrically. Kruskal-Wallis test with Dunnett’s multiple comparison post-test was done to compare CSF-ADA activity in different groups. ROC curve analysis was done for CSF-ADA cutoff value. Result: Mean CSF-ADA (U/L) value in TBM patients were significantly higher (24.37±10.73) than in PM (14.28±5.979), AM (10.32±5.554) and Controls (6.520±4.801), p-value <0.0001 in TBM vs AM and TBM vs Controls. A cut-off value of 13.3 U/L gave a sensitivity of 91% and specificity of 90% when used to diagnose TBM. Conclusion: CSF-ADA is not only simple, cost effective and rapid but also fairly sensitive and specific in diagnosis of TBM, especially in dilemma of differentiating the tuberculous etiology from non-infectious one. For these reasons CSF-ADA is a well performer as an ancillary test of TBM.
Authors and Affiliations
Chatterjee Gangadhar, Chandel Rittu, Choudhary Nikhil, Abichandani Leela G
Keywords
Related Articles
- EP ID EP242433
- DOI -
- Views 119
- Downloads 0
Perinatal complications in intrahepatic cholestasis of pregnancy
Background and Objective: Intrahepatic cholestasis of pregnancy (ICP) is seen usually in 3 rd trimester of pregnancy. Overall incidence is 1.2-1.5% of Indian pregnant women. The biochemical abnormalities often include ra...
Role of serum lipoprotein (a) in type 2 diabetes mellitus and its association with glycemic control
Diabetes mellitus DM is an established risk factor for cardiovascular disease At present global risk assessment lipid profile is only the blood test routinely recommended most commonly Increased lipoprotein a Lpa contrib...
Liver enzymes and glycemic control markers in uncontrolled type 2 diabetes mellitus- A case control study
Introduction: Mild increase in liver enzymes, may be a marker for significant liver injury. The increased transaminases and hepatomegaly are found to be reversible with glycemic control. Objectives: 1. To compare the liv...
Serum total bilirubin and alanine transaminase levels in hyperthyroidism
Thyroid hormones are essential for normal growth, development and function of all tissues of the body by regulating basal metabolic rate of all cells, including hepatocytes. The present study was taken up to show the cor...
Establishment of reference range for thyroid hormones (T3, T4 & TSH) in adult female population at clinical biochemistry laboratory of GCS medical college & hospital- A descriptive study
Aim To establish reference range of T3 T4 and TSH of adult female population at Clinical Biochemistry Laboratory GCS Hospital AhmedabadMaterials and Methods The study was conducted among 151 healthy females who had under...