Role of Cerebrospinal fluid Lactate Dehydrogenase in meningitis (original) (raw)
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Significance of CSF-LDH in various types of meningitis
The cerebrospinal fluid concentration of Lactate dehydrogenase (LDH) was studied in patients with pyogenic and tubercular meningitis. Significant increase in LDH level (P<0.001) were observed in the test group when compared to the control group. LDH may useful in differentiating viral from other meningitis. It may act as corroborative evidence of meningitis.
Estimation of Lactate Dehydrogenase Activity in cerebrospinal fluid in different types of meningitis
International journal of Advanced Biological and Biomedical Research, 2017
Objective: Meningitis is life-threatening condition and examination of the Cerebrospinal fluid (CSF) may not give a precise diagnosis and prognosis of different types of meningitis. Bacterial meningitis is still a very common problem especially in many developing countries. The aims of study are to estimate the importance and significance of Lactate Dehydrogenase (LDH), protein and sugar in CSF of different types of meningitis. Methods: A total of 160 cases, aged between 1 month and 60 years, including patients with bacterial meningitis (n=50), pyogenic meningitis (n=46), viral meningitis (n=24) and a control group (n=40), were analyzed on the basis of data from the initial clinical examinations. Results: Significant increase in LDH level (P<0.001) were observed in the test group when compared to the control group. The LDH activity was significantly elevated in the CSF and serum (p < 0.001) in cases of pyogenic (PM) as well as tuberculous meningitis (TBM). Bacterial meningiti...
Comparison of clinical and CSF profiles in 62 Adults with tuberculous and pyogenic meningitis
International Journal of Research in Medical Sciences, 2017
Background: Many a times differentiating tuberculous meningitis from pyogenic meningitis becomes very difficult. The diagnosis depends upon clinical manifestation and cytochemical analysis of cerebrospinal fluid (CSF). Many researchers found that the CSF glucose: protein ratio less than 0.5 and Adenosine deaminase levels (ADA) in cerebrospinal fluid are useful to differentiate tubercular disease from non-tubercular meningitis.Methods: Sixty-two patients admitted to our tertiary hospital with symptoms and signs of meningitis were selected and divided into two groups: tubercular (n=39) and pyogenic (n= 23), depending upon the accepted criteria. Clinical features and CSF parameters noted in each patient. Cut off value of ADA kept at or above 10 IU/L for tubercular meningitis.Results: The mean age of patients with tubercular meningitis was 39.07±16.67 years and that of pyogenic meningitis 34.35±16.73 years. Clinically fever was present in 60 (96.77%), headache in 49 (79.03%), and vomiti...
Analysis of Cerebrospinal Fluid Analytes in Bacterial and Tuberculous Meningitis
2018
Objective: Meningitis is the severe and lethal infection spread worldwide. The most common forms of meningitis are viral and bacterial meningitis caused by Neisseria meningitides and other species. Tuberculous meningitis (TBM) is the most mortal form of Mycobacterium tuberculosis infection, which has a high rate of neurological complications and sequelae. The best method for diagnosis of meningitis is cerebrospinal fluid analysis (CSF). The purpose of present study is to determine the CSF examination (glucose and protein levels) of subjects with bacterial meningitis (BM) and TBM and their comparison with healthy individuals. Study Design: Cohort Study. Place and Duration of study: The study was conducted in Children Medical Complex Hospital Multan, during February 2016 to June 2016. Materials and Methods: The data of 75 children (25 of TBM, 25 of BM and 25 of normal) with age <5 years was collected. The analysis of CSF protein and glucose levels was done by standard methods. The...
IP innovative publication pvt. ltd, 2019
Introduction: Meningitis is a serious clinical problem in many regions of the world especially in the developing countries. Early diagnosis and appropriate treatment of the type of meningitis is crucial to reduce associated mortality and morbidity. The role of CSF lactate in the differential diagnosis between pyogenic from nonpyogenic meningitis has been debatable for long. We investigated the diagnostic value of CSF lactate in meningitis patients for discriminating between pyogenic and nonpyogenic meningitis in our institute for two years. Materials and Methods: A cross-sectional study was done in 40 cases of suspected meningitis of varied etiologies from October 2011 to October 2013. CSF samples were taken immediately on admission. Based on CSF cytology and biochemical parameters and other specific assays, patients were divided into pyogenic, tubercular and aseptic/viral meningitis. CSF lactate was estimated by the ISE (Ion-selective electrode) method. Results: Of the 40 patients with meningitis, 16 were pyogenic and 24 nonpyogenic (9 tubercular and 15 aseptic/viral). Mean CSF lactate levels was 11.66 mmol /L, 4.0 mmol /L and 1.99 mmol /L in pyogenic meningitis, tubercular meningitis and viral meningitis respectively (P<0.001). Mean CSF lactate was significantly high in pyogenic meningitis and tubercular meningitis compared to viral meningitis. Using a higher cut off value of 5 mmol/L, CSF lactate helped in differentiating pyogenic from tubercular meningitis (P<0.001). Conclusion: CSF lactate can provide legitimate, quick and explicit diagnostic information in differentiating pyogenic from nonpyogenic meningitis (tubercular and viral).
JPMA. The Journal of the Pakistan Medical Association, 2013
To compare the clinical and laboratory features of tuberculous meningitis with bacterial meningitis and to determine if protein glucose ratio in the cerebrospinal fluid can be predictive of the condition. It was a retrospective descriptive study at the Paediatric Ward of Aga Khan University Hospital, Karachi, for which records of 46 patients with tuberculous meningitis and 33 with bacterial meningitis were reviewed. All records related to the study period that was from January 2005 to October 2010. The records were retrieved in December 2010. Tuberculous meningitis was defined as illness > or = 14 days, basal enhancement or tuberculoma on computerised tomography scan and response to anti-tuberculous therapy. Pyogenic meningitis was defined by the presence of a pathogenic isolate inthe cerebrospinal fluid (bacterial culture) or by positive latex particle agglutination or a pathogen on cerebrospinal fluid gram stain and clinical improvement with antibiotics. Logistic regression was...
Introduction : Meningitis is a life threatening infection of protective membranes covering the brain and the spinal cord, known as meninges. It is a common disease worldwide with high mortality and morbidity and remains a major international health problem. It is one of the common cause of hospital admission. It can present with fever, headache, neck rigidity, seizures, lethargy, drowsiness or coma in varied combinations. Objective : To study the epidemiology of meningitis in adults and role of Creatine kinase and lactate Dehydrogenase in its diagnosis. Methodology : A observational, cross sectional and institution based study conducted among 50 patients above 12 years of age admitted in a tertiary care centre with features suggestive of meningitis. 25 individuals were taken as control as per guidelines. Study was conducted from the month of January 2017 to September 2017. Patients were selected presenting signs and symptoms of meningitis after satisfying inclusion and exclusion criteria. Parameters like detailed history, through clinical examination, ECG and imaging studies were taken. Result : Majority of the patients 44% (44 patients) belonged to the adult age group 26-40 years. In the study 98% patients with meningitis presented with fever. All patients with pyogenic, viral and tubercular meningitis had headache. Seizures was present in 16.66% of tubercular meningitis and 37.5% of pyogenic meningitis. Clinical presentation of the disease is similar to features documented by other studies. Patients with clinical diagnosis of meningitis had increased LDH and CK in serum Conclusion : Inspite of many advents of sophisticated methods of investigations, diagnosis of meningitis remains a puzzle for physicians. In present study CSF enzymes like LDH and CK which remain significantly high compared to controls, hence their estimation gives an important clue to the diagnosis of meningitis.
CSF Proteins as Discreminatory Markers of Tubercular and Pyogenic Meningitis
JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH, 2013
Introduction: Meningitis is still a major cause of illness in many parts of the world. Though substantial improvement has been occurred in the diagnosis of meningitis, conclusive differentiation between tubercular and pyogenic meningitis remains to be an unsolved problem. Patients with meningitis often have severe neurological deficit or die inspite of antibiotic therapy. Thus, improvement in diagnostic test and therapy is required. The objective of the present study was to find a simple biochemical marker for diagnosis of meningitis and differentiation of tubercular and pyogenic meningitis. Material and Methods: CSF samples were collected from 90 paediatric patients from Nilofer Hospital, Hyderabad, India, from age group of 4 months to 12 years. CSF samples were collected by performing Lumbar Puncture under aseptic conditions and with required precaution. CSF samples were divided into 3 groups where Group 1 included Control that was without CSF inflammation, Group 2 with Tuberculous Meningitis & Group 3 consisting of Pyogenic Meningitis with 30 samples in each group. Electrophoretic analysis of CSF proteins was performed which separated as bands of pre-albumin, albumin, alpha, beta and gamma globulins. Result: Protein content in CSF was 259 ± 409 mg/dl in tuberculous meningitis, whereas in pyogenic meningitis it was 111 ± 83.94 mg/dl and in control group was 19 ± 13.3 mg/dl. Electrophoretic analysis revealed pre-albumin band to be 2.8 ± 1.2 % in tuberculous meningitis, which was significantly decreased when compared with control and pyogenic meningitis. Albumin band in tuberculous meningitis was 34.8 ± 9.9 %, which was also significantly decreased when compared to control and pyogenic meningitis. Alpha band was 19.7 ± 6.9 % in pyogenic meningitis, but in control and tubeculous meningitis it was 10.4 ± 2.9% and 10.3 ± 5.2% respectively. Beta band was found similar in all the three groups. Gamma band was 33.2 ± 8.08% in tuberculous meningitis, 13.8 ± 4.55% in control and 16.7 ± 13.18% in pyogenic meningitis. Conclusion: Pre-albumin band was found to be decreased and gamma band was shown to be increased in tuberculous meningitis. Alpha band was increased in pyogenic meningitis. Thus, CSF protein fraction separated and quantitated by native Polyacrylamide slab gel electrophoresis, could be used as markers in differentiation of tubercular and pyogenic meningitis.
https://www.ijhsr.org/IJHSR\_Vol.10\_Issue.8\_Aug2020/IJHSR\_Abstract.01.html, 2020
The objective of this study was to compare the mean values of CSF parameters (lactate, protein, sugar, ADA) and thereby distinguish between cases of bacterial and non-bacterial meningitis. A cross sectional study was conducted in which 60 adult patients were included and CSF parameters (differential counts, protein, sugar, ADA, lactate) were analyzed in 22 patients of bacterial meningitis and 38 patients of aseptic meningitis. Data were analyzed using SPSS version 21.0. Analytical statistics were represented using Chi-square test for the comparison of categorical variables. The mean values were compared using independent t-test. Among the other CSF parameters, the mean value of CSF lactate and CSF sugars were found to have significant difference (p-value 0.01) in bacterial and non-bacterial meningitis. However other parameters including CSF protein and CSF ADA did not show significant difference between bacterial meningitis including TBM and non-bacterial meningitis. This study concluded that CSF lactate is an important, independent and reliable biomarker with a cut off value of 3mmol/L, to differentiate bacterial meningitis including TBM from nonbacterial meningitis. TBM and viral meningitis are difficult to differentiate due to their similar clinical features and lab parameters. In such cases, CSF lactate can be taken as a reliable differentiating marker. CSF lactate can be used when CSF gram stain and cultures are inconclusive and time consuming. Thus, helps in initiating early treatment and achieving better outcomes.
Serum ADA Levels and LDH Levels in Tubercular Meningitis in Paediatric Patients
Introdction: Fall in the physiologic concentration of glucose in the cerebrospinal fluid (CSF) is the most common finding observed in patients with tuberculous meningitis (TM) and bacterial meningitis. In back 1980, for the first time, alteration in the lactate concentrations was detected in the CSF of the patients with TM. Hence; we evaluated the levels of adenosine deaminase (AD) and LD in paediatric patients with TM having adverse neurological outcome and compared it with the levels in TM patients without adverse outcome. Material and Methods: The present study included all the paediatric patients that were admitted to the ward with the chief problem of TM. TM cases were further staged with severity following the classification of British Medical Research Council classification. CSF LD and CSF AD were measured in all the cases of TM by standard photometric assays and Berthelot method respectively. All the results were assessed and analyzed by SPSS software. Student t test and chi-square test was used for the assessment of level of significance. Results: As far as staging of the disease is concerned, patients with TM group with adverse outcome, the mean staging was 2.8 while in the other group, the mean staging of the patients was 1.8. Non-significant results were obtained while comparing the demographic details of the patients in the two study groups. However, as far as staging of the disease is concerned, significant difference was observed in between the two study groups. Mean AD level in the patients of TM with adverse outcome and in patients without adverse outcome was 17.5 and 11.5 IU/L respectively. When evaluating the mean LD level among patients with and without adverse outcome, the value was observed to be 40.8 and 33.9 IU/L respectively. Significant difference was observed while comparing the mean value of AD level among patients of the two study groups. Conclusion: Further substantial evidences are required for standardizing the CSF AD and LD levels as diagnostic and prognostic markers in diagnosing the cases of TM.