Heparin Binding Protein in Early Differential Diagnosis of Bacterial Meningitis

Heparin-binding protein is a serine protease that is mobilized rapidly from emigrating polymorphonuclear leukocytes that acts as a chemoattractant activator of monocyte and macrophages. We investigated the potential role and efficacy of serum and cerebrospinal fluid heparin binding protein in differentiating bacterial meningitis from tuberculosis and viral meningitis. A case diagnosed with acute bacterial meningitis (n:37), viral meningitis (n:30) and tuberculous meningitis (n:30) was included in this study. The diagnosis was based on history, clinical criteria, cerebrospinal fluid examination, latex agglutination and culture, and response to therapy. Heparin-binding protein was measured using enzyme-linked immunosorbent technique in both cerebrospinal fluid and serum. Cerebrospinal fluid heparin-binding protein levels were 7.81 ± 0.23 ng/mL in bacterial meningitis, 6.11 ± 0.3 ng/mL in tuberculosis meningitis and 5.75 ± 0.1 ng/mL in viral meningitis. The mean serum level was 14.98 ± 1.1 ng/mL in bacterial meningitis, 6.89 ± 0.4 ng/mL in tuberculosis meningitis, and 6.02 ± 0.4 ng/mL in viral meningitis. Both heparin-binding protein levels were significantly higher in patients with bacterial meningitis. We found that serum and cerebrospinal fluid heparin binding protein is a useful marker for differentiating bacterial meningitis from non-bacterial meningitis.