Evaluation of lactate dehydrogenase isoenzyme activity and biochemical profile in cerebrospinal fluid for different types of meningitis

Ranbeer Kumar Singh, Dipak Kushwaha, Syed S. Haque, Md. Tanweeruddin, Tarique Aziz, B. K. Singh, Kalpana Singh

Abstract


Meningitis is life-threatening condition and examination of the cerebrospinal fluid (CSF) may not give a precise diagnosis and prognosis of different types of meningitis. Bacterial meningitis is still a very common problem especially in many developing countries. The aims of study are to estimate the importance and significance of lactate dehydrogenase (LDH) isoenzymes, protein and sugar in CSF of different types of meningitis. A total of 160 cases, aged between 1 month and 60 years, including patients with bacterial meningitis (n=50), pyogenic meningitis (n=46), viral meningitis (n=24) and a control group (n=40), were  analyzed on the basis of data from the initial clinical examinations. Significant increase in LDH level (P<0.001) were observed in the test group when compared to the control group. The LDH activity was significantly elevated in the CSF and serum (p < 0.001) in cases of pyogenic (PM) as well as tuberculous meningitis (TBM). Bacterial meningitis is more common than non bacterial meningitis. The enzymatic activity of LDH although significantly raised in PM compared to TBM but there was no cutoff level to differentiate them. The LDH level did rise quite significantly in pyogenic meningitis.

Keywords


Lactate dehydrogenase (LDH); Cerebrospinal fluid (CSF); Meningitis

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References


Harman CR, Van Heerden JA, Farley DR, Grant CS, Thompson GB, Curlee K. Sporadic primary hyperparathyroidism: a separate disease entity? Arch Surg. 1999; 134: 651-656.

McArthur JC, Nance-Sproson TE, Griffin DE, Hoover D, Selnes OA, Miller EN, et al. The diagnosis utility of elevation in cerebrospinal fluid beta 2-microglobulin in HIV-1 dementia. Neurology. 1992; 42: 1707-1712.

Watson MA, Scott MG. Clinical utility of biochemical analysis of cerebrospinal fluid. Clin Chem. 1995; 41(3): 343-360.

Wallach J. Interpretation of diagnostic tests. 6th ed. Boston: Little, Brown & Co; 1996: 13-15.

Tunkel AR, Michael SW. Acute meningitis. In: Principle and practice of infectious disease. Mandell GL, Dollin RG, Bennett JE, eds. Churchill Livingstone/Elsevier, Philadelphia, 2010: 1083-1119.

Roos KL, Tyler KL. Meningitis. In: Harrison principle of internal medicine. Kasper DL, Braunwald E, Fauci AS, Hauser SL, Longo DL, et al., eds. MC Graw Hill, New York, 2008: 2471-2490.

Feigin RD, Pearlman E. Bacterial meningitis beyond the neonatal period. In: Text book of pediatric infectious disease. Feigin RD, Demmler GJ, Cherry JD, Kaplan SL, eds. Saunders, Philadelphia, 2004: 443-474.

Kanoh Y, Ohtani H. Levels of interleukin-6, CRP and alpha 2 macroglobulin in cerebrospinal fluid (CSF) and serum as indicator of blood-CSF barrier damage. Biochem Mol Biol Int. 1997; 43(2): 269-278.

Paradowski M, Lebos M, Kuydowicz J, Krakowiak M, Kubasiewicz-Ujma B. Acute phase proteins in serum and cerebrospinal fluid in the course of bacterial meningitis. Clin Biochem. 1995; 28(4): 459-466.

Sormunen P, Kallio MJT, Kilpi T, Peltola H. C-reactive protein is useful in distinguishing gram stain-negative bacterial meningitis from viral meningitis in children. J Pediatr. 1999; 134(6): 725-729.

Gendrel D, Raymond J, Oste J, Moulin F, Lorrot M, Guérin S, et al. Comparisson of procalcitonin with C-reactive protein, interleukin 6 and interferon-alpha for differentiation of bacterial vs. viral infections. Pediatr Infect Dis J. 1999; 18(10): 875-881.

Jadali F, Sharifi M, Jarollahi A, Nahidi S. C-reactive protein and lactate dehydrogenase in serum and cerebrospinal fluid in rapid and early diagnosis of childhood meningitis. Iran J Child Neurol. 2009; 1(4): 37-46.

Sormunen P, Kallio MJ, Kilpi T, Peltola H. C-reactive protein is useful in distinguishing Gram stain-negative bacterial meningitis from viral meningitis in children. J Pediatr. 1999; 134(6): 725-729.

Snyder RD. Bacterial meningitis: diagnosis and treatment. Curr Neurol Neurosci Rep. 2003; 3(6): 461-469.

Sharma M, Nand N. Evaluation of enzymes in pyogenic and tuberculous meningitis. J Assoc Physicians India. 2006; 54: 118-121.

Nussinovitch M, Finkelstein Y, Elishkevitz KP, Volovitz B, Harel D, Klinger G, et al. Cerebrospinal fluid lactate dehydrogenase isoenzyme in children with bacterial and aseptic meningitis. Transl Res. 2009; 154(4): 214-218.

Wroblewski, F, Decker B, Wroblewski R. The clinical implications of spinal fluid LDH activity. N Engl J Med 1958; 258: 635-639.

Lending M, Slobody LB, Mestern J. Cerebrospinal fluid glutamic oxalacetic transaminase and lactic dehydrogenase activities in children with neurologic disorders. J Pediatr. 1964; 65: 415-421.

Aicardi J. Disease of the nervous system in childhood. Clin Dev Med 1992; 1115(118): 1132-1135.


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