Early differentiation of chronic meningitis by enzyme assay

Abstract

Samples of CSF [cerebrospinal fluid] from a number of patients with chronic meningitis were assayed for beta glucuronidase and acid betaglycerophosphatase activity. High to extremely high values were found without exception in those patients who later proved to have diffuse meningeal dissemination of neoplasm, while those in the other categories studied generally had normal to moderately elevated enzyme activities. Patterns of variation in enzyme activity during successful therapy were described, and possible reasons for the elevated activities in some forms of chronic meningitis were discussed. A high activity on initial lumbar puncture, in the absence of a significant number of polymorphonuclear cells, constitutes sufficient grounds to utilize the necessarily large volumes of CSF for repeated cytologic studies for detection of neoplastic cells.