A Case Control Study for Diagnostic Significance of Cerebrospinal Fluid (CSF) & Serum Lactate Dehydrogenase (LDH) and Total Creatine Kinase (CK) Level in Meningitis
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Date
2024-07
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FORUM: Fraternity of national Research & pUblication Society of Medical sciences
Abstract
Introduction : Meningitis is the most common sequalae to microbial invasion of the CNS. Neurological sequalae are serious and rather common among survivors. Meningitis disturbs the blood brain barrier (BBB) and is expected to cause rise in enzymatic activity. For that reason some enzymes are used for the diagnosis in cases of meningitis. Since prompt and precise etiological diagnosis remains a challenge and often a thorough cerebrospinal fluid examination may not give a precise diagnosis, a quick and reliable test is required for rapid bedside diagnosis. This study was planned to find out the role of diagnostic significance of CSF & serum LDH & Total CK levels in meningitis. AIM : Diagnostic significance of CSF & serum LDH & Total CK levels in meningitis. Objectives : To measure and estimate the level of Cerebrospinal fluid (CSF) & Serum LDH & Total CK in pyogenic meningitis and tuberculous meningitis. Material and methods : This Case control study was carried out at Clinical Chemistry Laboratory, Medical College Baroda and Sir Sayajirao General (S.S.G.) Hospital, Vadodara. Approval of Institute’s Scientific Review Committee and Ethical Clearance were obtained from the Institutional Ethics Committee for Human Research, Medical College Baroda and S.S.G. Hospital, Vadodara. 30 diagnosed patients of Meningitis and 30 patients who were operated under spinal anesthesia (Patient who met with an accident without any major illness) between the age group of 18 to 60 years were enrolled in my study. Detailed history and record findings of examination were done as per proforma and data were recorded in proforma sheet. For laboratory investigation , 5 ml blood sample by venipunture was taken in plain vacutainer and 1 ml CSF sample by lumber puncture were collected in plain vacutainer. Blood and CSF samples were processed in clinical chemistry laboratory and tests were performed .Results: As defined in materials and methods, the study group consisted of 30 cases in group I (Clinically diagnosed cases of meningitis) and 30 age & sex matched controls in group II (Patients undergoing surgery under spinal anesthesia from Ortho and Surgery i.e patients with accidents were taken as Control).Statistical analyses were done by using unpaired Student’s t-test to find out significance of difference between two groups. The Mean ± SD of S. LDH ,CSF LDH, S. Total CK , CSF Total CK in group I and group II, were 232.10 ± 27.79 (161.0 – 280.1) IU/L, 248.68 ± 44.48 ( 148.0 – 320.8 ) IU/L, 201.34 ± 19.84 (167.8 – 236.7) IU/L, 31.80 ± 9.44 (18.2 – 56.0) IU/L, 140.01 ± 13.92 ( 115.2 – 167.0 ) IU/L, 35.73 ± 10.40 (18.9 – 66.9) IU/L, 115.87 ± 52.52 (29.0 – 198.0) IU/L, 7.89 ± 3.61 (3.9 -17.0) IU/L, respectively. There was statically significant difference found between these two groups. (P < 0.0001). The Mean ± SD of S. LDH , CSF LDH, S. Total CK , CSF Total CK in Pyogenic meningitis and Tuberculous meningitis in group I were 233.45 ± 30.43 (161 – 280.1) IU/L, 251.36 ± 46.66 (148.0 – 320.8 ) IU/L, 202.93 ± 19.70 ( 167.8 – 230.0) IU/L, 33.76 ± 9.80 ( 18.2 – 56.0 ) IU/L, 227.68 ± 17.54 ( 198.5 – 244.0 ) IU/L, 239.88 ± 38.20 (180.0 – 286.0 ) IU/L, 196.10 ± 20.93 (175.9 – 236.7 ) IU/L, 25.37 ± 3.92 (19.8 – 30.4) IU/L, respectively. There was statistically significant difference was not found in between Pyogenic meningitis and Tuberculous meningitis. (P > 0.05). Conclusion : This study was carried out to measure the levels of Lactate dehydrogenase (LDH) and Total Creatine Kinase (CK) in serum and Cerebrospinal fluid (CSF) in patients with meningitis. LDH and Total CK in serum and CSF may not be useful in differentiating types of meningitis but it may act as a corroborative evidence of meningitis. So along with routine CSF parameters CSF LDH and Total CK level may add in the diagnosis of meningitis
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CSF Meningitis, LDH, Total CK
Citation
Parmar Nikita, Makwana Manisha. A Case Control Study for Diagnostic Significance of Cerebrospinal Fluid (CSF) & Serum Lactate Dehydrogenase (LDH) and Total Creatine Kinase (CK) Level in Meningitis. Indian Journal of Applied Basic Medical Sciences. 2024 Jul; 26B(2): 1-11