Yonsei Med J.  2012 Nov;53(6):1068-1072. 10.3349/ymj.2012.53.6.1068.

Serum and Cerebrospinal Fluid Neuron-Specific Enolase for Diagnosis of Tuberculous Meningitis

• Song TJ
• Choi YC
• Lee KY
• Kim WJ

• KMID: 1414245
• DOI: http://doi.org/10.3349/ymj.2012.53.6.1068

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.

Keyword

Neuron-specific enolase; tuberculous meningitis

MeSH Terms

Adult
Case-Control Studies
Female
Humans
Logistic Models
Male
Middle Aged
Phosphopyruvate Hydratase/*blood/*cerebrospinal fluid
Tuberculosis, Meningeal/blood/*diagnosis/metabolism

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