title: Adenosine deaminase activity in cerebrospinal fluid and serum for the diagnosis of tuberculous meningitis.
abstract: OBJECTIVE
  To evaluate the usefulness of serum and CSF adenosine deaminase (ADA) activity for the diagnosis of tuberculous meningitis (TBM) from other meningitis.
  
  
  METHODS
  We studied CSF and serum ADA activity for 83 cases of TBM, 148 of bacterial meningitis (BM), and 262 of viral or aseptic meningitis.
  
  
  RESULTS
  The mean ADA activities (IU/L) in CSF and serum were higher in TBM (11.80 ± 2.50, 30.28 ± 7.30) than in other types of meningitis (8.52 ± 3.60, 17.90 ± 9.20 in BM; 5.26 ± 1.90, 8.56 ± 5.9 in viral or aseptic meningitis). When we accepted a serum ADA activity cut-off value of 15 IU/L for the differential diagnosis of TBM and non-TBM with ROC analysis, the sensitivity was 84% and specificity was 82%. Combining CSF (≥ 10) and serum (≥ 15) ADA activity significantly increased overall specificity from 92% to 97% for the diagnosis of TBM.
  
  
  CONCLUSIONS
  The determination of CSF and serum ADA activity is a simple and reliable test for differentiating TBM from other types of meningitis.
authors.affiliation: Department of Neurology, Chonnam National University Medical School, Gwangju 501-757, Republic of Korea.
authors.forename: Bang-Hoon
authors.initials: BH
authors.lastname: Cho
authors.forename: Byeong C
authors.initials: BC
authors.lastname: Kim
authors.forename: Geum-Jin
authors.initials: GJ
authors.lastname: Yoon
authors.forename: Seong-Min
authors.initials: SM
authors.lastname: Choi
authors.forename: Jane
authors.initials: J
authors.lastname: Chang
authors.forename: Seung-Han
authors.initials: SH
authors.lastname: Lee
authors.forename: Man-Seok
authors.initials: MS
authors.lastname: Park
authors.forename: Jong Hee
authors.initials: JH
authors.lastname: Shin
authors.forename: Myeong-Kyu
authors.initials: MK
authors.lastname: Kim
authors.forename: Ki-Hyun
authors.initials: KH
authors.lastname: Cho
mesh_terms: D000243:Adenosine Deaminase / Q000097:blood* / Q000134:cerebrospinal fluid*; D000328:Adult; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007958:Leukocyte Count; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D014390:Tuberculosis, Meningeal / Q000097:blood* / Q000134:cerebrospinal fluid* / Q000201:enzymology
chemical_list: D000243:Adenosine Deaminase
keywords: Adenosine deaminase (ADA); Cerebrospinal fluid (CSF); Serum; Tuberculous meningitis