Does CSF antibodies assay help in differentiating neurocysticercosis from tuberculoma?
Journal Title: IP International Journal of Medical Microbiology and Tropical Diseases - Year 2018, Vol 4, Issue 4
Abstract
Introduction Two common causes of ringdisc enhancing lesions in CT scan or MRI scan of brain are Cysticercosis and tuberculoma It is often difficult to know the cause in a patient with ringdisc lesionsThe gold standard being tissue diagnosis which is often not done or not practical due to procedural complications and most of these lesions carry a benign course The present study was undertaken to test the sensitivity and specificity of CSF antibodies in Definitive cases of Neurocysticercosis and TuberculomaMaterials and Methods A Crosssectional descriptive study was conducted with a sample size of 50 patients The duration of study was for 2 years Consecutive patients visiting the neurology department with complaints of seizures headache and focal neurological deficit and their neuroimaging demonstrating a ringdisc enhancing lesions suggesting either a Cysticercosis or Tuberculoma were included Patients were subjected to a detail clinical history and examination Complete hemogram complete blood chemistry HIV serology and Neuroimaging either MRI or CT brain were doneLumbar puncture was done in all patients if there were no contraindicationsCSF analysis for antibodies against antigens of cysticercosis and antitubercular antibodies were done Antibody estimation is done by ELISA methodResults There were 52 patients in the study of which 26 patients were diagnosed as Neurocysticercosis and 11 patients as Tuberculoma In all 26 patients with Cysticercosis CSF was showing less than 4 cells with normal glucose and protein Out of 11 patients with tuberculoma only one patient CSF study was abnormalCSF Elisa for anticysticeral and antitubercular antibodies were done in all patients and were negative in all themConclusion CSF ELISA test for anticysticercal antibody and anti tubercular antibody test has a low sensitivity and is not helpful in the diagnosis of ring enhancing lesions in the brainKeywords Neurocysticercosis Tubeculoma CSF Antibodies
Authors and Affiliations
Raghunandan Nadig, A K Roy, Thomas Mathew, GRK Sarma, Muralidharan Dr
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