Diagnostic value of cerebrospinal fluid adenosine deaminase determination

Abstract

We measured the activity of adenosine deaminase (ADA) in the cerebrospinal fluid of 3 patients with tuberculous meningitis, 38 with viral meningitis, 15 with bacterial meningitis, 5 with malignant lymphoma, 11 with cerebrovascular diseases and 13 with miscellaneous neurological disorders. The highest ADA activities were observed in patients with tuberculous meningitis (median 21.3 U/l, range 20.0-23.0) and lymphoma (13.0 U/l, range 4.0-25.0). The sensitivity of the test for diagnosing tuberculous meningitis was 100% and the specificity 99% when a cut-off value of 20.0 U/l was used. We conclude that determination of ADA in cerebrospinal fluid is useful for the diagnosis of tuberculous meningitis, but that high activity also can be seen in some other CNS disorders, e.g. lymphoma with meningeal involvement.

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).…”

Analysis of cerebrospinal fluid adenosine deaminase level in tuberculous meningitis and validation of sensitivity and specificity

“…6 Chotmongkol V et al identified a CSF ADA level of 15.5U/l as the best cut-off value to differentiate tuberculous meningitis and non-tuberculous meningitis, with a sensitivity of 75% and specificity of 93%. 7 When tuberculous meningitis was compared with aseptic and carcinomatous meningitis, a CSF ADA level of 19.0 U/l was the best cut-off value for differentiation, with a sensitivity of 69% and a specificity of 94%.…”

Meningitis bacteriana por Streptococcus pneumoniae con ADA extraordinariamente elevada

“…Aunque no hay un consenso con respecto al valor normal de ADA, varios estudios retrospectivos indican que una concentración mayor de 9 o 10 U/l en el LCR es muy sensible y específica para el diagnóstico de meningitis tuberculosa o de neurobrucelosis 1 . Además de las etiologías mencionadas, la ADA puede estar elevada en la meningitis sarcoidea 2 , la infiltración meníngea por leucemia o linfoma 3 , la toxoplasmosis cerebral, el infarto cerebral 3 , la meningitis criptocócica, la neurosífilis y otras meningitis asépticas 4 . Recientemente se ha descrito un caso de meningitis por Listeria con ADA elevada (12,3 U/l) 5 .…”