Matti Klockars

Diagnostic value of cerebrospinal fluid adenosine deaminase determination

We measured the activity of adenosine deaminase (ADA) in the cerebrospinal fluid of 3 patients with tuberculous meningitis, 38 with viral meningitis, 15 with bacterial meningitis, 5 with malignant lymphoma, 11 with cerebrovascular diseases and 13 with miscellaneous neurological disorders. The highest ADA activities were observed in patients with tuberculous meningitis (median 21.3 U/l, range 20.0-23.0) and lymphoma (13.0 U/l, range 4.0-25.0). The sensitivity of the test for diagnosing tuberculous meningitis was 100% and the specificity 99% when a cut-off value of 20.0 U/l was used. We conclude that determination of ADA in cerebrospinal fluid is useful for the diagnosis of tuberculous meningitis, but that high activity also can be seen in some other CNS disorders, e.g. lymphoma with meningeal involvement.

Carcinoembryonic antigen in pleural effusions: A diagnostic and prognostic indicator☆

Abstract The concentration of carcinoembryonic antigen (CEA) was determined in the serum and pleural fluid of 114 adult patients with a pleural effusion of various causes. With the cut-off level at 5 ng/ml , the serum level of CEA was raised in 46% of patients whose pleural effusion was caused by a malignant disease and in 7% of those with a pleural effusion caused by a non-malignant disease. The corresponding values in pleural fluid were 59% and 8% respectively. Among patients with malignant pleural effusion the difference in the survival rate at 6 months postassay between patients whose pleural fluid concentration of CEA was above and below 5 ng/ml was statistically significant ( P ). A poorer prognosis was observed among patients with tumours producing CEA.