Interpretation of mycobacterial antibodies in the cerebrospinal fluid of adults with tuberculous meningitis

Tropical Medicine & International Health : TM & IH
Blanca I RestrepoJaime Robledo

Abstract

Microbiological identification of Mycobacterium tuberculosis is insensitive and slow, and clinical distinction of tuberculous meningitis (TBM) from other subacute or chronic meningoenchephalitides (SACM) is difficult. Successful use of highly specific M. tuberculosis serological assays on cerebrospinal fluid has been reported, but their performance for diagnosis in a tuberculosis endemic country where they would be of most value is unclear. We sought to determine the biological basis for the uncertainty in interpretation of antibody detection in the CSF of TBM patients. We identified prospectively 46 adults with SACM and explored the concordance between TBM diagnosis and detection of highly specific M. tuberculosis antibodies in CSF. The source of antibodies in CSF was explored by evaluating the correlation between antibody titres in CSF with those in serum, or with the albumin quotient. Intrathecal IgG synthesis was assessed by the IgG index. Positive antibody titres were more frequent among TBM patients (76%), but were also present in individuals with other SACM (59%). A positive correlation between antibody titres in CSF with those in serum, or with the albumin quotient, supported the leakage of antibodies from plasma to CSF...Continue Reading

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Citations

Mar 5, 2010·Respirology : Official Journal of the Asian Pacific Society of Respirology·Christoph Lange, Toru Mori
Jan 24, 2014·American Journal of Respiratory and Critical Care Medicine·Guo-dong FengGang Zhao
May 14, 2016·International Journal of Infectious Diseases : IJID : Official Publication of the International Society for Infectious Diseases·T Y HuangY E Wu

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