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Immunologic Diagnosis of Tuberculous Meningitis.

Journal of the Korean Pediatric Society 1990;33(1):42-50.
Published online January 31, 1990.
Immunologic Diagnosis of Tuberculous Meningitis.
Nak Wan Choi, Hong Ro Lee, Pyung Han Hwang, Dae Yeul Lee, Jung Soo Kim
Department of Pediatrics, College of Medicine, Chonbuk National University, Chonju, Korea
결핵성 뇌막염의 면역학적 진단법에 관한 연구
최낙완, 이홍로, 황평한, 이대열, 김정수
전북대학교 의과대학 소아과학교실
Received: 20 September 1989   • Accepted: 5 October 1989
Abstract
One of the inherent features of clinical microbiology is that substantial time is required for the culture of infectious organisms. Especially acid fast bacilli require extensive time and labaratory facilities for reliable recovery. This makes it difficult for clinicians to use the results in early decisions concerning management of the patient. For these reasons, there has been increasing interest in developing or refining methods that allow direct detection and identification of microorganisms or specific immunoglobulins in clinical specimens. The purpose of this article is to define the diagnostic efficacy of ELISA method in tuberculous meningitis. PPD-specific Ig G was measured in serum and cerebrospinal fluid of tuber-culous meningitis patients using ELISA. 1) PPD-specific Ig G in CSF were significantly increased in tuberculous meningitis patients com- pare to those of control and non-tuberculous menigitis patients. 2) PPD-specific Ig G in CSF were relatively increased in patients with pulmonary tuberculosis compare to those in control group. 3) PPD-specific Ig G in serum were also increased and approximately the same level in patients with pulmonary tuberculosis regardless of meningeal involvement. However, PPD-specific Ig G in CSF were significantly increased in patients with meningitis compare to those in patients without meningitis. These results suggest that detecting PPD-specific Ig G in CSF using ELISA can be efficiently used for diagnosis of tuberculous meningitis. The increment of PPD-specific Ig G in CSF may be due to local production in central nervous system, and also in part a simple diffusion. Further studies will be required.
Key Words: PPD-specific IgG


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