Cerebrospinal Fluid–adenosine Deaminase Ativity in Tuberculous Meningitis Cases

Context: Tuberculosis remains one of the world’s deadliest diseases & tubercular meningitis is one of the most deadly complications due to missed diagnosis and delayed Treatment and result in significant morbidity and mortality. The signs and symptoms, results of routine analysis of CSF and radiographic findings for patients with CNS tuberculosis are often inadequate in making a definitive diagnosis. Aims: 1. To study the levels of Adenosine deaminase in CSF in cases of meningitis. 2. To evaluate the sensitivity and specificity of CSF-ADA as a diagnostic test in tuberculosis meningitis. Material and methods: In the cross sectional study, Adenosine deaminase activity (ADA) was studied in cerebrospinal fluid of 25 cases of tuberculous meningitis, 10 cases of pyogenic meningitis. 21 cases of aseptic meningitis and10 control subjects. Results: The mean CSF-ADA activity was 16.324±0.706 (tuberculous meningitis); 8.89±1.03 5.01±0.68 (pyogenic meningitis); 8.89±1.03 (aseptic meningitis) and 2.15±0.51 IU/L (control) respectively. The sensitivity and specificity of this test for diagnosis of tuberculous meningitis was 94.73% and 90.47% respectively with ADA value of more than 10 U/L. Conclusion: The adenosine deaminase levels in tuberculous meningitis cases was statistically significant. It can play a major role towards early diagnosis of tuberculous meningitis and help in treatment to prevent from fatal and morbid complications of tubercular meningitis.