Cerebrospinal Fluid Adenosine Deaminase Activity: A Valid Ancillary Test for Tubercular Meningitis

2016 ◽  
Vol 3 (2) ◽  
pp. 145
Author(s):  
Chatterjee Gangadhar ◽  
Chandel Rittu ◽  
Choudhary Nikhil ◽  
Abichandani G. Leela
Keyword(s):  
Cerebrospinal Fluid ◽  
Adenosine Deaminase ◽  
Tubercular Meningitis ◽  
Ancillary Test ◽  
Adenosine Deaminase Activity

scholarly journals Analysis of Cerebrospinal Fluid (CSF) – Adenosine Deaminase (ADA) in Meningitis

2021 ◽  
Vol 10 (16) ◽  
pp. 1102-1105
Author(s):  
Akkamahadevi V. Nipanal ◽  
Madhukumar M.H ◽  
Nagappa H
Keyword(s):  
Cerebrospinal Fluid ◽  
Early Diagnosis ◽  
Adenosine Deaminase ◽  
Viral Meningitis ◽  
Tubercular Meningitis ◽  
Acid Fast Bacilli ◽  
Group I ◽  
Adenosine Deaminase Activity ◽  
Function Test ◽  
The Mean

BACKGROUND Acute infections of the nervous system are generally widespread and cause significant problems in the field medicine and therefore early detection, right decision making, and early initiation of therapy can be lifesaving. Meningitis is the inflammation of the membranes that cover the brain and spinal cord. It is a general clinical problem during infancy and childhood. Delay in differentiating between bacterial, tubercular & viral meningitis and institution of its treatment may have irreparable consequences that lead to significant morbidity & mortality. The present study was conducted to find out the utility of cerebrospinal fluid-adenosine deaminase (CSF-ADA) for the early diagnosis & differentiation of tubercular & viral meningitis in adults. METHODS 50 meningitis patients who met the inclusion criteria were selected. Investigations including complete haemogram, liver function test (LFT), renal function test (RFT), random blood sugar (RBS), serum electrolytes, human immunodeficiency virus (HIV) test, chest x-ray and computed tomography (CT) brain (plain) were done. CSF cytology, biochemistry, gram stain, acid-fast bacteria (AFB) stain & culture were done. These cases were further divided in to two groups based on clinical and CSF laboratory findings as group I: tubercular meningitis, group II: viral meningitis. An estimation of CSF-ADA was done in all patients. RESULTS The mean age of the 50 patients studied was 37.76 + 15.58 years, with the maximum number of patients suffering from tubercular meningitis. The incidence of meningitis was more in males. CSF-adenosine deaminase activity was found to be higher in tubercular meningitis, the mean value was 17.67 ± 8.13 IU / L. CONCLUSIONS Assessment of CSF-ADA will be helpful for early diagnosis and differentiation of tubercular and viral meningitis. This is needed when gold standard investigations for meningitis like smear and / or culture for acid fast bacilli are not available or negative or are time consuming. KEY WORDS CSF-Cerebrospinal Fluid, ADA-Adenosine Deaminase, AFB-Acid Fast Bacilli.

Adenosine deaminase activity in cerebrospinal fluid

2013 ◽  
Vol 115 (12) ◽  
pp. 2555
Author(s):  
Aurore Bousquet ◽  
Sarah Bugier ◽  
Franck Ceppa ◽  
Hervé Delacour
Keyword(s):  
Cerebrospinal Fluid ◽  
Adenosine Deaminase ◽  
Adenosine Deaminase Activity

scholarly journals Comparative analysis of cerebrospinal fluid adenosine deaminase levels in infective meningitis of different aetiologies

2017 ◽  
Vol 4 (2) ◽  
pp. 608
Author(s):  
Mohsin Rashid ◽  
Sheikh Mushtaq ◽  
Junaid Manzoor ◽  
Javaid Ahmad Bhat ◽  
Shilakha Chaman ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Diagnostic Accuracy ◽  
Adenosine Deaminase ◽  
Aseptic Meningitis ◽  
Predictive Value ◽  
Cost Effective ◽  
Systemic Lupus Erythematosis ◽  
Pyogenic Meningitis ◽  
Tubercular Meningitis ◽  
High Level

Background: Meningitis can be caused by bacteria, viruses, parasites, and fungi as well as by non-infectious conditions including inflammatory disorders (e.g., systemic lupus erythematosis or Kawasaki disease) and neoplasia (e.g., leukemic meningitis). The objective of this study were to study cerebrospinal fluid (CSF) adenosine deaminase (ADA) levels in infective meningitis of different aetiologies. And to assess the role of cerebrospinal fluids (CSF) adenosine deaminase (ADA) levels in differentiating tubercular from non-tubercular meningitis.Methods: The study was conducted on 70 patients of meningitis at Postgraduate Department of Paediatrics, in G. B. Pant Hospital, an associated hospital of Government Medical College Srinagar. Out of 70 patients included in the study 27 cases were Aseptic Meningitis (AM), 14 cases partially treated pyogenic -meningitis (PTM), 19 cases pyogenic meningitis (PM), and 10 cases were tubercular meningitis (TBM). ADA activity of CSF was quantified by colorimetry.Results: In our study we observed a significant high level of ADA 30.0±3.2U/L (20.0, 54.0) among the tubercular meningitis (TBM) patients and its respective level among Aseptic Meningitis (AM), was 8.1±0.3U/L (4.0, 11.5), partially treated pyo -meningitis (PTM) was 7.6±0.4U/L (5.0, 11.0), pyogenic meningitis (PM) was 11.6±0.5U/L (8.0, 14.5). In total Non-TBM ADA level was 9.1±0.3U/L (4.0, 14.5) units/liter. At cut off of > or equal to 10U/L sensitivity was 100% specificity66.67% positive predictive value33.33% negative predictive value of 100% diagnostic accuracy 71.43%. At a higher cut off of > or equal to 12U/L sensitivity was 100% and specificity increased to 81.67% positive predictive value 47.62% negative predictive value100% diagnostic accuracy was 84.29%.Conclusions: The sensitivity and specificity of CSF ADA activity is markedly high in differentiating TBM from non-TBM. Hence CSF ADA activity may be used as a simple, cost-effective and reliable test for early diagnosis of TBM.

scholarly journals Role of cerebrospinal fluid adenosine deaminase activity in the diagnosis of tuberculous meningitis in children

2017 ◽  
Vol 4 (2) ◽  
pp. 411
Author(s):  
T. Hima Bindu ◽  
R. Maheshwara Reddy
Keyword(s):  
Cerebrospinal Fluid ◽  
Adenosine Deaminase ◽  
Tuberculous Meningitis ◽  
Mean Value ◽  
Successful Outcome ◽  
Correct Treatment ◽  
Cross Sectional ◽  
Adenosine Deaminase Activity ◽  
The Mean ◽  
Meningitis In Children

Background: Early and correct treatment is essential for successful outcome in patients of tuberculous men-ingitis. Adenosine deaminase activity in the cerebrospinal fluid has been found to be a simple and useful investigation in the diagnosis of tuberculous meningitis in children.Methods: It is a cross sectional observational hospital based study conducted at the Department of Paediatrics, Deccan College of Medical Sciences, Kanchanbagh, Hyderabad, India. Children aged 2 months to 12 years were included in the study during April 2016 to October 2016.Results: The mean value of adenosine deaminase activity in the cerebrospinal fluid of tuberculous meningitis cases was 13.3±14.49. The mean cerebrospinal fluid adenosine deaminase levels in tuberculous meningitis patients was significantly higher than non-tuberculous meningitis patients with P <0.01.Conclusions: The mean cerebrospinal fluid adenosine deaminase level was significantly raised in tuberculous meningitis patients.

Determination of cerebrospinal fluid adenosine deaminase activity cut-off for the diagnosis of tuberculous meningitis in Hong Kong

2020 ◽  
Vol 73 (12) ◽  
pp. 800-802
Author(s):  
Toby Chun Hei Chan ◽  
Sammy Pak Lam Chen ◽  
Chloe Miu Mak ◽  
Chor Kwan Ching ◽  
Kristine Shik Luk ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Hong Kong ◽  
Adenosine Deaminase ◽  
Likelihood Ratio ◽  
Tuberculous Meningitis ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Central Nervous System Lymphoma ◽  
Timely Initiation ◽  
Adenosine Deaminase Activity

AimsTuberculous meningitis (TBM) is a severe infection which may lead to serious complication and mortality. Prompt diagnosis and treatment are essential. There is a need for a simple and fast laboratory test to differentiate TBM from other causes.MethodsRetrospective review was conducted for cerebrospinal fluid adenosine deaminase (CSF-ADA) activity which was measured at the Chemical Pathology Laboratory of Princess Margaret Hospital, the sole centre providing such service in Hong Kong, for 51 patients with suspected meningitis from nine local hospitals between June 2014 and July 2017. TBM diagnosis was defined by positive culture and/or nucleic acid amplification test result of Mycobacterium tuberculosis complex in CSF.ResultsCSF-ADA activity was significantly higher in the TBM group (8.6±2.1 IU/L, n=8) than that of the non-TBM group (2.8±5.9 IU/L, n=43). The optimal clinical cut-off of 5.1 U/L for TBM diagnosis in our laboratory yielded 100% sensitivity, 91% specificity, positive likelihood ratio of 10.8 and negative likelihood ratio of 0. In rare circumstance, false elevation may be seen in non-tuberculous cause, such as central nervous system lymphoma and fungal infection.ConclusionsWe recommend the use of CSF-ADA activity, which is a simple, fast and robust test for early differentiation of TBM from other causes, to facilitate timely initiation of antituberculous treatment and potentially improve patients’ outcome.

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