Serum and Cerebrospinal Fluid Neuron-Specific Enolase for Diagnosis of Tuberculous Meningitis.
10.3349/ymj.2012.53.6.1068
- Author:
Tae Jin SONG
1
;
Young Chul CHOI
;
Kyung Yul LEE
;
Won Joo KIM
Author Information
1. Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea. kzoo@yuhs.ac
- Publication Type:Original Article
- Keywords:
Neuron-specific enolase;
tuberculous meningitis
- MeSH:
Adult;
Case-Control Studies;
Female;
Humans;
Logistic Models;
Male;
Middle Aged;
Phosphopyruvate Hydratase/*blood/*cerebrospinal fluid;
Tuberculosis, Meningeal/blood/*diagnosis/metabolism
- From:Yonsei Medical Journal
2012;53(6):1068-1072
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: Late diagnosis and treatment lead to high mortality and poor prognosis in tuberculous meningitis (TbM). A rapid and accurate diagnosis is necessary for a good prognosis. Neuron-specific enolase (NSE) has been investigated as a biochemical marker of nervous tissue damage. In the present study, the usefulness of NSE was evaluated, and a cut-off value for the differential diagnosis of TbM was proposed. MATERIALS AND METHODS: Patient charts were reviewed for levels of serum and cerebrospinal fluid (CSF) NSE, obtained from a diagnostic CSF study of samples in age- and gender-matched TbM (n=15), aseptic meningitis (n=28) and control (n=37) patients. RESULTS: CSF/serum NSE ratio was higher in the TbM group than those of the control and aseptic groups (p=0.001). In binary logistic regression, CSF white blood cell count and CSF/serum NSE ratio were significant factors for diagnosis of TbM. When the cut-off value of the CSF/serum NSE ratio was 1.21, the sensitivity was 86.7% and the specificity was 75.4%. CONCLUSION: The CSF/serum NSE ratio could be a useful parameter for the early diagnosis of TbM. In addition, the authors of the present study suggest a cut-off value of 1.21 for CSF/serum NSE ratio.
