Early diagnosis of tuberculous meningitis by detection of anti-BCG secreting cells in cerebrospinal fluid.
A nitrocellulose immunospot assay to enumerate cells secreting anti-BCG antibodies was evaluated in the diagnosis of tuberculous meningitis. Among 25 Chinese patients with this disease diagnosed on clinical and cerebrospinal fluid (CSF) criteria, 24 had anti-BCG IgG antibody secreting cells in CSF, at a median value of 56 per 10(4) CSF cells. Among 6 patients examined within one week, 5 had antibody secreting cells in CSF, and all 19 patients examined 2-8 weeks after onset had such cells in CSF. Blood examined from 5 patients contained anti-BCG IgG or IgM antibody secreting cells, but usually at much lower numbers than in corresponding CSF, indicating that the specific antibody response is largely confined to CSF. Anti-BCG antibodies measured in parallel by ELISA were slightly raised in CSF in only 1 of the 6 patients examined within a week, whereas a good correspondence was seen between numbers of antibody secreting cells and antibody concentrations from the second week onwards. Detection of anti-BCG IgG antibody secreting cells has higher sensitivity and specificity than ELISA measurement of anti-BCG IgG antibodies, and represents a new, useful method for the early diagnosis of tuberculous meningitis.
Lu
C Z
CZ
Institute of Neurology, Shanghai Medical University, China.
Qiao
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J
Shen
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D000293:Adolescent; D000328:Adult; D000907:Antibodies, Bacterial / Q000134:cerebrospinal fluid*; D002648:Child; D002675:Child, Preschool; D004797:Enzyme-Linked Immunosorbent Assay / Q000379:methods; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000134:cerebrospinal fluid*; D007075:Immunoglobulin M / Q000134:cerebrospinal fluid*; D008297:Male; D008875:Middle Aged; D009163:Mycobacterium bovis / Q000276:immunology*; D011237:Predictive Value of Tests; D011379:Prognosis; D013997:Time Factors; D014390:Tuberculosis, Meningeal / Q000134:cerebrospinal fluid / Q000175:diagnosis*
D000907:Antibodies, Bacterial; D007074:Immunoglobulin G; D007075:Immunoglobulin M