Cut-Off Value Adenosine Deaminase Activity In Cerebrospinal Fluid For Diagnosis Of Tuberculous Meningitis

BACKGROUNDTuberculous meningitis is a serious clinical problem with significant morbidity and mortality.The objectives of the study are- 1. to estimate the cerebrospinal fluid adenosine deaminase levels in suspected cases of meningitis and 2. to evaluate the utility of Cerebrospinal-ADA levels as a diagnostic test in tuberculous meningitis.MATERIALS AND METHODSIt is a descriptive study. Adenosine deaminase activity (ADA) was studied in cerebrospinal fluid of 42 cases of tuberculous meningitis, 13 cases of pyogenic meningitis, 19 cases of aseptic meningitis and 20 cases of controls (patients without any neurological problem who were given spinal anaesthesia). Sample size taken for convenience.RESULTSThe mean cerebrospinal fluid adenosine deaminase activity was 13.1 +/- 1.96 U/L in tuberculous meningitis, 5.91 +/- 1.27 U/L in pyogenic meningitis, 2.62 +/- 1.03 for aseptic meningitis and 1.45 +/- 0.44 U/l for controls. 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 98.44% respectively with ADA value of more than 12 U/L.CONCLUSIONAdenosine deaminase activity in CSF is a quick, relatively inexpensive and simple procedure, can be of great value in the diagnosis of tuberculous meningitis, help in earlier institution of suitable treatment and thereby prevent morbidity, mortality and other complications.