Open AccessCerebrospinal fluid adenosine deaminase levels as a diagnostic marker in tuberculous meningitis in adult Nepalese patients
Author(s) -
Anil Chander,
Chandrika Devi Shrestha
Publication year - 2013
Publication title -
asian pacific journal of tropical disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.208
H-Index - 33
ISSN - 2222-1808
DOI - 10.1016/s2222-1808(13)60004-3
Subject(s) - tuberculous meningitis , medicine , cerebrospinal fluid , adenosine deaminase , viral meningitis , gastroenterology , meningitis , surgery , bacterial meningitis , adenosine
Objective: To study the cerebrospinal fluid (CSF) adenosine deaminase (ADA) levels in\udtuberculous meningitis (TBM) and non-TBM -viral meningitis cases and to determine its\uddiagnostic significance as a biochemical marker of TBM infection.Methods: The study population\udcomprised two different patient groups. TBM - group I - 28 cases and non-TBM-viral meningitis\ud- 22 cases. These were enrolled consecutively in the study and CSF specimens were collected\udfrom them. ADA estimation was carried out by spectrophotometry.Results: ADA levels (mean依\udSD) in the TBM and non-TBM groups were 16.46依6.24 U/L and 5.13依2.96 U/L, respectively (highly\udsignificant P<0.001). Using a CSF ADA cut off reference value of >10 IU/L, the test showed a good\udsensitivity of 82.14% (95% CI 64.41-92.12) and a high specificity of 90.91% (95% CI 72.19-97.47).\udPositive and negative predictive value and positive and negative likelihood ratios and accuracy\udof the test in TBM cases were 92% (95% CI 75.03-97.77), 80% (95% CI 60.86-91.13), 9.03 (95% CI 2.38-\ud34.25), 0.19 (95% CI 0.09-0.44) and 86%, respectively.Conclusion: CSF ADA levels are elevated in\udthe TBM cases as compared to the non-TBM - viral meningitis cases with a good sensitivity and\uda high specificity. It is a simple and inexpensive diagnostic adjunctive test in the rapid and early\uddiagnosis of TBM