Journal of Neurology

, Volume 253, Issue 10, pp 1323–1330

Interferon γ quantification in cerebrospinal fluid compared with PCR for the diagnosis of tuberculous meningitis

  • Rafael San Juan
  • Carmen Sánchez-Suárez
  • María J. Rebollo
  • Dolores Folgueira
  • Elia Palenque
  • Blanca Ortuño
  • Carlos Lumbreras
  • José M. Aguado
ORIGINAL COMMUNICATION

DOI: 10.1007/s00415-006-0215-y

Cite this article as:
Juan, R.S., Sánchez-Suárez, C., Rebollo, M.J. et al. J Neurol (2006) 253: 1323. doi:10.1007/s00415-006-0215-y

Abstract

Purpose

To assess the utility of interferon γ (INF-γ) levels in cerebrospinal fluid (CSF), for the diagnosis of tuberculous meningitis (TBM), and compare these results with aPCR technique.

Methods

We studied CSF samples from patients with proven or probable TBM and a control group, composed by patients with other causes of meningitis and without meningitis. INFγ levels were measured by radioimmunoassay. A PCR technique was performed using IS6110 primers.

Results

Of the 127 patients studied, 20 (15.6%) had TBM, 59 (46%) had meningitis of another aetiology and 49 (38.4%) had were HIV and non-HIV patients with normal CSF. The area below the ROC curve for interferon γ levels in the diagnosis of TBM was 0.94. A cut-off of 6.4 IU/mL yielded a sensitivity of 70% and a specificity of 94%. False positive results were observed in 7 of the 59 patients (11.8%) with non-TB meningitis, (patients with herpetic meningoencephalitis and meningitis due to intracellular microorganisms). INF-γ sensitivity was higher than PCR (70% vs. 65%). Both tests performed together showed higher sensitivity (80%) and specificity (92.6%).

Conclusion

CSF INF-γ levels (> 6.4 IU/mL) are very valuable in TBM diagnosis. PCR and INF-γ could be simultaneously used to increase the diagnostic yield.

Keywords

tuberculosisInterferon gammaPCRmeningitis

Copyright information

© Steinkopff Verlag Darmstadt 2006

Authors and Affiliations

  • Rafael San Juan
    • 1
  • Carmen Sánchez-Suárez
    • 2
  • María J. Rebollo
    • 1
  • Dolores Folgueira
    • 3
  • Elia Palenque
    • 3
  • Blanca Ortuño
    • 4
  • Carlos Lumbreras
    • 1
  • José M. Aguado
    • 1
  1. 1.Infectious Diseases UnitHospital General Universitario “Doce de Octubre”MadridSpain
  2. 2.Dept. of NeurologyUniversity Hospital “12 de Octubre”MadridSpain
  3. 3.Clinical MicrobiologyUniversity Hospital “12 de Octubre”MadridSpain
  4. 4.Nuclear MedicineUniversity Hospital “12 de Octubre”MadridSpain