Differential Diagnosis of Cerebral Malaria by CSF ADA, Serum ADS and its Ratio
Journal Title: People's Journal of Scientific Research. - Year 2016, Vol 9, Issue 1
Abstract
A case control study was conducted comparing CSF ADA, Serum ADA and its ratio for differentiating cerebral malaria from viral encephalitis in the Department of Pediatrics, M.L.B. Medical College, Jhansi during January 2010 – October 2011. Patients admitted with history of fever, convulsion and altered sensorium were enrolled in the study and further divided in three groups comprising of Cerebral Malaria, Viral Encephalitis and Control Group. Lumber puncture were performed in all three groups and ADA estimation was done. The statistical analysis was performed by using chi square test to find out the significance of difference. For determination of cutoff value for parameters, coordinates of ROC curve indicating the greatest sensitivity and specificity were chosen. Fifty two patients of cerebral malaria, 56 patients of viral encephalitis and 54 controls were recruited for the study over 2 year period. Patients with cerebral malaria had significantly higher serum ADA, CSF ADA but lower CSF/ serum ADA compared to control (p<0.01) as well as to viral encephalitis (p<0.01). Serum ADA of >78.9, CSF ADA of >6.31 and CSF/Serum ADA ratio of ≤ 0.093 were selected as the cutoff value with highest sensitivity and specificity for differentiation between two conditions. ADA estimation in CSF and Serum is a rapid, simple, and reliably specific test to differentiate cerebral malaria from viral encephalitis. Therfore, this test can be used to avoid diagnostic dilemma. ADA estimation in cerebral malaria patients should find place in routine laboratory methodology.
Authors and Affiliations
Deepak Pandey, , O Chaurasiya, , D Nath
Keywords
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