Neuron-specific enolase, nucleotides, nucleosides, purine bases, oxypurines and uric acid concentrations in cerebrospinal fluid of children with meningitis.
To determine the effects of meningitis on cerebral energy metabolism, cerebrospinal fluid concentrations of adenosine monophosphate, inosine monophosphate, inosine, adenosine, guanosine, adenine, guanine, hypoxanthine, xanthine and urate were determined by high-performance liquid chromatography, and neuron-specific enolase by an enzyme immunoassay method, in 100 children with meningitis (45 bacterial, 46 viral and nine tuberculous), aged between 1 month and 13 years, and in 160 age-matched controls. Compared with controls, patients with bacterial meningitis showed high concentrations of hypoxanthine, xanthine and urate; patients with viral meningitis showed high concentrations of inosine, guanosine, xanthine, urate and neuron-specific enolase; and patients with tuberculous meningitis showed very high concentrations of inosine, xanthine and urate. Xanthine and urate concentrations were significantly higher in patients with tuberculous meningitis than in patients with viral or bacterial meningitis. These results suggest that in the acute stage of bacterial, viral and tuberculous meningitis, neuronal energy metabolism may be altered. The measurement of cerebrospinal xanthine and uric acid concentrations may be useful for the early diagnosis of a tuberculous origin.
Rodríguez-Núñez
Antonio
A
Department of Pediatrics, Hospital Clínico Universitario de Santiago, Complejo Hospitalario Universitario de Santiago, Choupana, s/n, 15706, Santiago de Compostela, Spain.
Cid
Elena
E
Rodríguez-García
Javier
J
Camiña
Félix
F
Rodríguez-Segade
Santiago
S
Castro-Gago
Manuel
M
D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008581:Meningitis / Q000134:cerebrospinal fluid* / Q000175:diagnosis; D016920:Meningitis, Bacterial / Q000175:diagnosis; D008587:Meningitis, Viral / Q000175:diagnosis; D009705:Nucleosides / Q000134:cerebrospinal fluid; D009711:Nucleotides / Q000134:cerebrospinal fluid; D010751:Phosphopyruvate Hydratase / Q000134:cerebrospinal fluid; D011687:Purines / Q000134:cerebrospinal fluid; D012016:Reference Values; D014390:Tuberculosis, Meningeal / Q000175:diagnosis; D014527:Uric Acid / Q000134:cerebrospinal fluid
D009705:Nucleosides; D009711:Nucleotides; D011687:Purines; D014527:Uric Acid; D010751:Phosphopyruvate Hydratase