Serum and cerebrospinal fluid neuron-specific enolase for diagnosis of tuberculous meningitis.

Tae-Jin Song, Young-Chul Choi, Kyung-Yul Lee, Won-Joo Kim

Yonsei medical journal 2012 Nov 01

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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. 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. 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%. 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.

Citation

Tae-Jin Song, Young-Chul Choi, Kyung-Yul Lee, Won-Joo Kim. Serum and cerebrospinal fluid neuron-specific enolase for diagnosis of tuberculous meningitis. Yonsei medical journal. 2012 Nov 01;53(6):1068-72