All issues > Volume 33(1); 1990

Original Article

J Korean Pediatr Soc. 1990;33(1):42-50. Published online January 31, 1990.

Immunologic Diagnosis of Tuberculous Meningitis.

Nak Wan Choi¹, Hong Ro Lee¹, Pyung Han Hwang¹, Dae Yeul Lee¹, Jung Soo Kim¹

¹Department of Pediatrics, College of Medicine, Chonbuk National University, Chonju, Korea

Received: September 20, 1989;  Accepted: October 5, 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.

Keywords :PPD-specific IgG