Activity of Adenosine Deaminase in Cerebrospinal Fluid for the Diagnosis and Follow-Up of Tuberculous Meningitis in Adults

Abstract

We studied the activity of adenosine deaminase in the cerebrospinal fluid of 40 normal controls and 205 patients who were grouped according to disease (tuberculous, viral, and purulent meningitis; neoplasms; stroke; and miscellaneous). The mean enzyme value was clearly higher for the patients with tuberculous meningitis (15.7 +/- 4.3 U/liter) than for the other patients (1.4 +/- 1.5 U/liter). The sensitivity of the test for diagnosing tuberculous meningitis was 1 and specificity, 0.99. The enzyme activity, as well as progression of the disease, was studied in 32 patients with tuberculous meningitis. A significant rise in levels of enzyme was observed during the first 10 days of therapy, was followed by a gradual decline, and reached normal values after three to four months of treatment. Two patients showed substantial increases that coincided with the development of complications. The test proved to be a simple and reliable method for early diagnosis and follow-up of tuberculous meningitis.

Adenosine deaminase and C-reactive protein in cerebrospinal fluid for differential diagnosis of tubercular meningitis in children

“…Similarly CSF-CRP by latex agglutination is a useful test for bacterial meningitis with reported high sensitivity (12,13,14).The mean ADA value in our study was 12.12±3.13 IU/L for TBM group and was significantly higher (p<0.001) than the partially treated pyogenic meningitis (5.39±2.70 IU/L) and aseptic meningitis (1.92±0.56 IU/L). There has been conflicting report regarding the diagnostic value of ADA in children as compared to adults, in whom 96-100% sensitivity has been, described (5,6,17). Our study confirms the utility of ADA as diagnostic test for TBM in children.…”

“…ADA is an enzyme with principal biologic activity in Tlymphocytes (10). Raised levels have been used as diagnostic marker in many studies (5)(6)(7)(8)(9)11). Similarly CSF-CRP by latex agglutination is a useful test for bacterial meningitis with reported high sensitivity (12,13,14).The mean ADA value in our study was 12.12±3.13 IU/L for TBM group and was significantly higher (p<0.001) than the partially treated pyogenic meningitis (5.39±2.70 IU/L) and aseptic meningitis (1.92±0.56 IU/L).…”

Cerebrospinal fluid Adenosine deaminase: its evaluation as a marker for diagnosing tuberculous meningitis in paediatric patients.

“…Ribera et al have also demonstrated similar finding but his study was in TBM patients of adult age group [8] .…”

“…The level of 15.7-21.3 has been observed in adult TBM patients [7,8] . These results show that levels of ADA vary in different age groups in TBM.…”

“…The levels of ADA in CSF of adult patients of TBM have been evaluated in earlier studies [6][7][8] . Elevated levels of ADA in CSF are not specific to meningeal inflammatory disease but it can be a test for confirming its etiology with good predictive value.…”