Role of cerebrospinal fluid adenosine deaminase activity in the diagnosis of tuberculous meningitis in children

Thapa, Bindu; Reddy, Rathan

doi:10.18203/2349-3291.ijcp20170537

Cited by 3 publications

(4 citation statements)

References 6 publications

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“…Several studies, including ours, have suggested the use of ADA levels for the diagnosis of PTB and EPTB. Gupta et al in a study evaluated ADA in 40 CSF samples and reported 94.73% sensitivity and 90.47% specificity in differentiating TBM from non-TBM [14,15] Previously we have also reported a sensitivity of 82% and specificity of 83% in 281 TBM and non-TBM patients [10]. However, in this study, we have taken a high number of samples (n=7498) as compared to previous studies, but the sensitivity and specificity are more or less similar to earlier studies [7].…”

Section: Discussionmentioning

confidence: 99%

Section: Eptb (Tbm [Csf Sample] Tbar [Synovial Fluid]) and Atb [Pleural Fluidascitic Fluid Abdominalmentioning

confidence: 97%

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Performance of Adenosine Deaminase assay in diagnosis of pulmonary & extrapulmonary tuberculosis

Kawle

Hutke

et al. 2021

Preprint

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Adenosine Deaminase (ADA) estimation in all forms of tuberculosis (TB) is done by several investigators, however, there has been a lot of debate about the use of the ADA for TB diagnosis. In the present study, to overcome this debate, we have planned a large scale study in the Central India population for all forms of TB i.e. pulmonary TB (PTB), tuberculous meningitis (TBM), TB arthritis (TBAR), and abdominal tuberculosis (ATB) to access the performance of ADA for diagnosis of TB. In addition to that, we have also studied the performance of the ADA test in the prognosis of TB. ADA activity was evaluated using the method of Guisti and Galanti. To evaluate the role of the ADA test as a prognostic marker in TB, we have collected follow-up clinical samples of PTB and TBM cases. The sensitivity of the ADA test is impressive in all forms of TB clinical samples analyzed for the study (PTB [82%], TBM [85%] TBAR [85%]), and (ATB) [84%]. However, the specificity was variable as ADA test results were found to be satisfactory for extrapulmonary TB (EPTB) cases ( i.e TBM [89%], (ATB) [88%], TBAR [88%]), on the other hand, poor specificity was observed in PTB cases (PTB [48%]). In the follow-up clinical samples (collected before and after anti-TB treatment [ATT]). In the follow-up samples, the result of the ADA test was observed to have declined drastically thereby showing a negative value after the ATT. Our study, which consists of a large number of samples, suggests that the ADA has very limited value in the diagnosis of PTB, and hence it is not recommended for PTB diagnosis. On the other hand, the ADA test is found to be useful for the diagnosis of EPTB in correlation to the patient's clinical condition. Along with the above-mentioned aspects and according to our follow-up study results, we recommend that ADA be useful as a prognostic indicator for TB.

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Section: Discussionmentioning

confidence: 99%

Section: Eptb (Tbm [Csf Sample] Tbar [Synovial Fluid]) and Atb [Pleural Fluidascitic Fluid Abdominalmentioning

confidence: 97%

Performance of Adenosine Deaminase assay in diagnosis of pulmonary & extrapulmonary tuberculosis

Kawle

Hutke

et al. 2021

Preprint

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“…ADA is an element of cellular immunity, its activity being increased in diseases in which cellular immunity is involved, a fact also found in TBM. The sensitivity of ADA varies between 60-90% and the specificity between 80-90%, but the method has not yet been well standardized and is not routinely recommended in the diagnosis of TBM [24,25]. The detection of M.tuberculosis specific antibodies or antigens in the CSF is a rapid method of diagnosing TBM.…”

Section: Csf Examinationmentioning

confidence: 99%

Hydrocephalus in Tuberculous Meningitis

Caliman-Sturdza¹,

Cucu²

2023

Frontiers in Hydrocephalus

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Hydrocephalus is a frequent complication of tuberculous meningitis. We present the incidence of hydrocephalus in patients diagnosed with tuberculosis of the nervous system, the therapeutic possibilities and the evolution of these patients. A consensus definition for tuberculous meningitis (TBM) stratified the cases as definite, probable and possible. In various studies, radiological investigations (CT, MRI) can be normal in the initial stages of the disease in approximately 30% of cases, but they do not exclude the possibility of a TBM. The most common radiological changes found in TBM are communicating hydrocephalus (up to 80% of cases), increased basal contrast (50%), cerebral tuberculomas (30%) and cerebral infarcts (10–40%). MRI has been shown to be more sensitive than a CT scan for diagnosed TBM. Communicating hydrocephalus is among the short-term complications of TBM (approximately 80% of cases), being more frequent than non-communicating ones. In these cases, the need to perform a ventriculo-peritoneal unit must be taken into account. Long-term complications are cognitive impairment, epilepsy, stroke, hydrocephalus, myelitis, damage to the hypothalamus or the pituitary gland manifested by obesity, growth disorders and diabetes insipidus. Sequels may occur frequently in TBM such as dementia, epilepsy, neurological deficits, behavioral disorders, blindness and deafness.

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“…A cutoff value of 10 U/L for patients with TBM gave a sensitivity and specificity of 90.62% and 95.65%, respectively; thus proving that CSF ADA activity is a rapid and affordable adjunct in differentiating TBM from non-TBM. [ 7 ] CSF ADA measurements have been found to be useful in predicting poor neurological outcomes among pediatric TBM cases. [ 8 ]…”

Section: Q: W Hat I S the S mentioning

confidence: 99%

Pediatric tubercular meningitis: A review

Aulakh

Chopra

2018

J Pediatr Neurosci

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Childhood tuberculosis (TB) has a high incidence and prevalence in developing countries like India with tubercular meningitis (TBM) being the most common cause of death. Most cases of TBM are diagnosed late when despite adequate therapy; morbidity and mortality continue to remain high. This review aims to provide a pragmatic approach at dealing with cases of tubercular meningitis in children including clinical features, laboratory and radiological criteria, treatment options and prognostic implications. The objective of this review is to assist in early identification, proper investigation and timely treatment of TBM in children in order to reduce neurological morbidity and mortality associated with it.

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Role of cerebrospinal fluid adenosine deaminase activity in the diagnosis of tuberculous meningitis in children

Cited by 3 publications

References 6 publications

Performance of Adenosine Deaminase assay in diagnosis of pulmonary & extrapulmonary tuberculosis

Performance of Adenosine Deaminase assay in diagnosis of pulmonary & extrapulmonary tuberculosis

Hydrocephalus in Tuberculous Meningitis

Pediatric tubercular meningitis: A review

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