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Differential diagnosis of tuberculous meningitis from partially-treated pyogenic meningitis by cell ELISA

Rajpal S Kashyap1, Rani P Kainthla, Ravindra M Satpute

  • 1Biochemistry Research Laboratory, Central India Institute of Medical Sciences, 88/2 Bajaj Nagar, Nagpur-440010, India. raj_ciims@rediffmail.com <raj_ciims@rediffmail.com>

BMC Neurology
|October 23, 2004
PubMed
Abstract

Insights

A new cell enzyme-linked immunosorbant assay (Cell ELISA) can differentiate tuberculous meningitis (TBM) from partially-treated pyogenic meningitis (PTPM). The assay detects specific B cell responses to a 30-kD protein antigen in cerebrospinal fluid (CSF).

Area of Science:

  • Neuroscience
  • Immunology
  • Infectious Diseases

Background:

  • Tuberculous meningitis (TBM) poses diagnostic challenges, often confused with partially-treated pyogenic meningitis (PTPM).
  • A specific 30-kD protein antigen in cerebrospinal fluid (CSF) and differential lymphocyte responses were previously identified in TBM patients.

Purpose of the Study:

  • To develop a diagnostic assay for distinguishing between TBM and PTPM.

Main Methods:

  • A cell enzyme-linked immunosorbant assay (Cell ELISA) was developed.
  • This assay quantifies antibody production against the 30-kD protein by B cells from CSF.

Main Results:

  • The Cell ELISA demonstrated 92% sensitivity and 92% specificity in differentiating TBM from PTPM.
  • B cells from TBM patients produced IgG antibodies within 24 hours when stimulated with the 30-kD antigen.

Conclusions:

  • CSF B cells from TBM patients exhibit a rapid IgG production response to the 30-kD antigen.
  • CSF B cells from PTPM patients do not show this response, enabling differential diagnosis.

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