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Diagn Cytopathol. 2015 Sep;43(9):701-4. doi: 10.1002/dc.23284. Epub 2015 Jun 10.

Prediction of cerebrospinal fluid parameters for tuberculous meningitis.

Zou Y1,2,3, He J1,2,3, Guo L1,2,3, Bu H1,2,3, Liu Y1,2,3.

Author information

1
Department of Neurology, the Second Hospital of Hebei Medical University Shijiazhuang, Hebei, People's Republic of China.
2
Hebei Institute of Cardio-Cerebral Vascular Diseases, Shijiazhuang, Hebei, People's Republic of China.
3
Hebei Key Laboratory for Neurology, Shijiazhuang, Hebei, People's Republic of China.

Abstract

BACKGROUND:

Tuberculous meningitis is the most lethal form of tuberculosis, but current diagnostic methods are inadequate. The measurement of cerebrospinal fluid parameters can provide early information for diagnosis. The present study focus on the validity of the cut-off value of cerebrospinal fluid parameters according to the Lancet consensus of scoring system for diagnosis of tuberculous meningitis.

METHOD:

A total of 100 confirmed patients were enrolled in this study. We evaluated significance of protein level (>1 g/l), chloride level (<120 mmol/l), glucose level (<2.2 mmol/l), cell counts (10-500 cells/μl, lymphocytic pleocytosis (>50%), and neutrophil predominance (>50%) in early diagnosis of tuberculous meningitis.

RESULT:

The cerebrospinal fluid parameters were significantly different between the tuberculous meningitis group and the control group. The independent factors for diagnosis of tuberculous meningitis were protein level (>1 g/l), glucose level (<2.2 mmol/l), cell counts (10-500 cells/μl and neutrophil predominance >50%). Neutrophil predominance (>50%) performed the best with the area under the curve of 89.7%. The sensitivity of protein level (>1 g/l), glucose level (<2.2 mmol/l), cell counts (10-500 cells/μl) and neutrophil predominance (>50%) for diagnosis of tuberculous meningitis were 66%, 58%, 86%, and 54%, and the specificity were 84%, 98%, 32%, and 98%. There are 84% patients in tuberculous meningitis group at least having two positive parameters among the four independent parameters, while only 10% in control group.

CONCLUSION:

The cerebrospinal fluid parameters can help the clinicians to make a prompt diagnosis in the early stage of the disease.

KEYWORDS:

cerebrospinal fluid; diagnostic value; tuberculous meningitis

PMID:
26061723
DOI:
10.1002/dc.23284
[Indexed for MEDLINE]

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