title: Evaluation of cerebrospinal fluid adenosine deaminase activity for the differential diagnosis of tuberculous and nontuberculous meningitis.
abstract: BACKGROUND
  The diagnosis value of adenosine deaminase (ADA) activity in cerebrospinal fluid (CSF) of tuberculous meningitis (TBM) has been well documented. However, the cutoff point of CSF ADA has not been fully assessed. In the current study, the authors set to calculate the cutoff points of ADA and monitor the changes of CSF ADA activities in patients with TBM after antitubercular therapy.
  
  
  METHODS
  CSF ADA activity in patients with different types of meningitis was measured by Trinder enzyme-coupled assay.
  
  
  RESULTS
  The mean CSF ADA values in the patients with TBM, bacterial meningitis, viral meningitis, cryptococcal meningitis and noninfectious neurologic disorders were 14.1 ± 5.4, 9.6 ± 5.5, 4.3 ± 2.5, 7.8 ± 3.4 and 2.6 ± 1.3 U/L, respectively. CSF ADA activity was significantly higher in TBM compared with patients with non-TBM (P < 0.05). Moreover, the best cutoff point for differentiating between TBM and non-TBM was 9.5 U/L. In addition, CSF ADA activity was decreased in patients with TBM after antitubercular therapy in a time-dependent manner.
  
  
  CONCLUSIONS
  The determination of ADA with a cutoff value of 9.5 U/L in CSF is a useful aid for the differential diagnosis of TBM and non-TBM. Moreover, dynamic monitoring of CSF ADA activity may be an indicator for evaluating antitubercular therapy in TBM.
authors: Department of Tuberculosis, Shanghai Pulmonary Hospital, Tongji University School of Medicine, China.
authors: Qin
authors: Q
authors: Sun
authors: Wei
authors: W
authors: Sha
authors: He-ping
authors: HP
authors: Xiao
authors: Qing
authors: Q
authors: Tian
authors: Hong
authors: H
authors: Zhu
mesh_terms: D000243:Adenosine Deaminase / Q000134:cerebrospinal fluid* / Q000592:standards; D000293:Adolescent; D000328:Adult; D000368:Aged; D000995:Antitubercular Agents / Q000627:therapeutic use; D015415:Biomarkers / Q000134:cerebrospinal fluid; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D008581:Meningitis / Q000175:diagnosis / Q000188:drug therapy / Q000201:enzymology; D008875:Middle Aged; D012189:Retrospective Studies; D014390:Tuberculosis, Meningeal / Q000175:diagnosis* / Q000188:drug therapy / Q000201:enzymology; D055815:Young Adult
chemical_list: D000995:Antitubercular Agents; D015415:Biomarkers; D000243:Adenosine Deaminase