Validity of adenosine deaminase levels in cerebrospinal fluid in tuberculous meningitis- a study from north bihar
Journal Title: INTERNATIONAL JOURNAL OF CURRENT RESEARCH - Year 2017, Vol 9, Issue 3
Abstract
Background: Incidence of Tubercular meningitis (TBM) in developing countries is 7-12%. About 25 % patients have poor prognosis because of delay in diagnosis. The aim of the present study is to find a simple, rapid, cost effective diagnostic test in differentiating tubercular etiology from other causes. Methods: Sixty-two patients admitted to our tertiary hospital with symptoms and signs of meningitis were selected and divided into two groups: tubercular (n=39) and pyogenic (n= 23), depending upon the accepted criteria. CSF examination done in each patients and adenosine deaminase (ADA) level estimated. Cut off value of ADA kept at or above 10 IU/L for tubercular meningitis. Results: The mean age of patients with tubercular meningitis was 39.07 ± 16.67 years and that of pyogenic meningitis 34.35 ± 16.73 years. Out of 39 tuberculous patients, 33 patients were found to be having CSF ADA at or above the cutoff value of 10 IU/L while six had below cutoff value. In tubercular meningitis, the ADA level in CSF ranged between 7 to 112 U/L with mean± SD as 35.72 ± 32.83 IU/L, while in pyogenic meningitis, the ADA level ranged between 2.4 to 7 IU/L with a mean ± SD as 4.21± 1.35 IU/L. On comparison between two groups, the CSF ADA level found to be statistically highly significant (P < 0.001). Conclusions: our study showed that estimation of ADA in CSF is not only simple, inexpensive and rapid but also fairly specific method for making a diagnosis of tuberculous meningitis. For this reason we recommend CSF ADA estimation in TBM.
Authors and Affiliations
Dr. Munish Kumar, Dr. Rahul Ranjan Dr. Hrishikesh Chakraborty, Manoj Kumar Rastogi, Dr. Kamlesh Tewary
Keywords
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