%0 Journal Article
%T Cerebrospinal fluid adenosine deaminase activity: A complimentary tool in the early diagnosis of tuberculous meningitis
%A Rajpal S Kashyap
%A Rani P Kainthla
%A Anju V Mudaliar
%A Hemant J Purohit
%A Girdhar M Taori
%A Hatim F Daginawala
%J Fluids and Barriers of the CNS
%D 2006
%I BioMed Central
%R 10.1186/1743-8454-3-5
%X ADA activity in CSF was determined according to a method based on the Berthlot reaction, which is the formation of a colored indophenol complex from ammonia liberated from adenosine, and quantified spectrophotometrically.The CSF ADA activity from TBM patients was compared with CSF ADA from non-TBM infectious meningitis patients, and from patients with non-infectious neurological disorders. The mean CSF ADA activity was found to be significantly higher in CSF of TBM patients, 14.31 ¡À 3.87 (2.99¨C26.94), mean ¡À SD with range, than in the CSF from non-TBM infectious meningitis, 9.25 ¡À 2.14 (4.99¨C13.96) and from the non-infectious neurological disorders group, 2.71 ¡À 1.96 (0.00¨C7.68), P < 0.0001 for both comparisons. A cut-off value of 11.39 U/L/min for the TBM patients was calculated from the mean + SD of the non-TBM patients. The ADA test gave a sensitivity of 82% and a specificity of 83% for infectious TBM when this cut-off value was used.This study demonstrated that ADA activity in the CSF of TBM patients, using a cut-off value 11.39 U/L/min, can be useful for the early differential diagnosis of TBM. This test can be performed in any pathology laboratory where more sophisticated methods are not available.Tuberculous meningitis (TBM) is the infection of the meninges caused by Mycobacterium tuberculosis (MTB). The diagnosis of TBM is complicated as it causes various clinical manifestations, which overlap with those of other chronic diseases of the central nervous system (CNS) such as viral and pyogenic meningitis [1]. The initiation of anti-TB medication in suspected TBM patients can often be delayed because of a lack of confidence in the presently available laboratory tests [2,3]. Most of the tests developed for the early diagnosis of TBM are not sensitive [4] and although some other tests are useful, they may not be affordable for routine use [5,6]. A reliable and rapid diagnostic test, which can be performed in any standard pathology laboratory, could be of help in
%U http://www.fluidsbarrierscns.com/content/3/1/5