THE SIMULTANEOUS DETERMINATION OF CEREBROSPINAL-FLUID AND PLASMA ADENOSINE-DEAMINASE ACTIVITY AS A DIAGNOSTIC-AID IN TUBERCULOUS MENINGITIS

Abstract

The simultaneous determination of cerebrospinal fluid (CSF) and plasma adenosine deaminase (ADA) activity was evaluated as a diagnostic aid in tuberculous meningitis (TBM). CSF and plasma ADA activity were determined in four groups of patients: (i) a ''no meningitis'' group of 174 children investigated for possible meningitis, but found to be uninfected; (ii) an aseptic meningitis group of 40 children; (iii) a bacterial meningitis group of 31 children; and (iv) a TBM group of 27 patients (24 children and 3 adults). CSF ADA alone was determined in a further 23 children with aseptic meningitis, 19 with bacterial meningitis and 13 children and 7 adults with TBM. Both the CSF/plasma ADA ratio and the absolute CSF ADA activity were raised in TBM (mean values 0,24 and 12,61 U/l respectively) and bacterial meningitis (mean values 0,59 and 15,43 U/l respectively), but not in the aseptic meningitis group (mean values 0,06 and 2,00 U/l) or the ''no meningitis'' group (mean values 0,04 and 1,51 U/l). Both values will distinguish TBM from aseptic meningitis, but do not appear to hold any marked advantages over conventional CSF criteria in the diagnosis of TBM.