A STUDY ON ADENOSINE DEAMINASE AND C-REACTIVE PROTEIN IN CEREBROSPINAL FLUID OF MENINGITIS PATIENTS OF DIFFERENT TYPES.

Abstract

Introduction: The three commonest types of Meningitis are Bacterial, Viral and Tubercular; they differ in their pathophysiology and management. That is why early differentiation between them is important. Bacterial meningitis have heavy fatality rates whereas Tubercular meningitis inicts severe neurological sequalae. Aims & Objectives: To determine whether ADA and CRP can be used successfully to predict the type of Meningitis affection Methodology: This is a Hospital based cross-sectional observation study which was undertaken in Biochemistry dept. Medical College, Kolkata. Eighty cases of meningitis were taken. ADA and CRP was measured along with Protein, Sugar and Differential staining cell counting. The cases were divided into three groups (Bacterial, Viral, and Tubercular) on the basis of microscopic and Biochemical Examination. Results & Analysis: ANNOVA test was done along with Bon Ferronis Test which revealed that there was signicant difference in mean of ADA & CRP in the three different groups.ROC curve for CRP between Reactive and Non-reactive meningitis revealed that if CRP values are more than 11.0, 95% of the cases were reactive whereas ROC curve for ADA between Tubercular and Non Tubercular forms showed when the concentration was more then 9.0, 95% of the cases were of Tubercular origin. Conclusion: When taken together ADA and CRP successfully predict the type of Meningitis. It is also helpful in diagnosing those cases when the Cell count and type was equivocal.