ADENOSINEDEAMINASE ACTIVITY IN CEREBROSPINAL FLUID FOR DIAGNOSIS OF TUBERCULOSIS MENINGITIS

Background:Tuberculous meningitis remains a serious clinical problem. Missed diagnosis and delayed treatment result in significant morbidity and mortality. Aims and Objectives: The study was aimed to estimate the cerebrospinal fluid adenosine deaminase levels in clinically suspected cases of meningitis and to evaluate the usefulness of CSF-ADA as a diagnostic test in tuberculosis meningitis.Methods: Adenosine deaminase activity (ADA) was studied in cerebrospinal fluid of 30 cases of tuberculous meningitis, 10 cases of pyogenic meningitis. 14 cases of aseptic meningitis and 15 controls (patients without any neurological disorders who were given spinal anesthesia).Results: The mean cerebrospinal fluid adenosine deaminase activity was 14.1±1.96; 4.92±1.27; 3.66±1.03 and 1.69±0.44 U/l in tuberculous meningitis, pyogenic meningitis, aseptic meningitis and control respectively. The adenosine deaminase activity in tuberculous meningitis cases was significantly higher. The sensitivity and specificity of this test for diagnosis of tuberculous meningitis was 100 % and 97.44% respectively with ADA value of more than 10 U/L. Conclusion: Adenosine deaminase activity in CSF is a rapid, relatively inexpensive and easy procedure, can be of great value in the early diagnosis of tuberculous meningitis, help in earlier institution of appropriate treatment and thereby prevent mortality and complications