Evaluating the Role of Cerebrospinal Fluid Adenosine Deaminase Levels in Diagnosing Tubercular Meningitis

Abstract

Background: Tubercular meningitis (TBM) is a severe form of central nervous system (CNS) tuberculosis, characterized by high morbidity and mortality rates. Early and accurate diagnosis is crucial for effective treatment. Adenosine deaminase (ADA) levels in cerebrospinal fluid (CSF) have been investigated as a potential biomarker for TBM.

Objective: This study aims to evaluate the diagnostic efficacy of adenosine deaminase levels in cerebrospinal fluid for patients with tubercular meningitis.

Material and Methods: A total of 40 patients diagnosed with tubercular meningitis were included in this cross-sectional study conducted in the Department of Medicine at a tertiary care hospital. CSF samples were obtained from each patient, and ADA levels were measured using a colorimetric assay. The results were compared with clinical findings and other diagnostic tests, including acid-fast bacilli (AFB) smear, culture, and polymerase chain reaction (PCR) for Mycobacterium tuberculosis.

Results: Of the 40 patients, 30 (75%) had elevated ADA levels (>10 IU/L), consistent with a diagnosis of TBM. The sensitivity and specificity of ADA levels in diagnosing TBM were found to be 87.5% and 80%, respectively, with a positive predictive value of 85% and a negative predictive value of 82%.

Conclusion: Adenosine deaminase levels in cerebrospinal fluid demonstrate significant diagnostic efficacy for tubercular meningitis, suggesting that it could be a valuable adjunct to current diagnostic methods.

Keywords: Tubercular meningitis, Adenosine deaminase, Cerebrospinal fluid, Diagnosis, Mycobacterium tuberculosis.