Diagnostic Values of Serum and CSF CRP in Tuberculous Meningits

ABSTRACT

C-reactive protein(CRP) of the serurn and CSF vras quantitatively measured in patients who were diagnosed as tuberculous meningitis(19 cases), aseptic meningitis(44 cases) and control group(23 cases) in order to evaluate the diagnostic value and the possible dynarnics of CRP between serum and CSF. Following results were obtained. 1. Significant difference(p<0.005) OF CRP was observed in the initial CSF of the patients with tuberculous meningitis and aseptic meningitis. When the CRP of CSF was set above 0.4rng /dl, a sensitivity of 0 79 apd a specificity of 0.90 were obtained. 2. When the CRP in the initial serurn as compared, significant difference(p<0.0210) was also observed between the patients with tuberculous rneningitis and aseptic meningitis. However, serurn CRP were not diagnostic because of significant overlap between the tuberculous and the aseptic meningitis. 3. On follow up measurement of CRP, patients with tuberculous meningitis showed signihcant decrease in both serurn and CSF while patients with aseptic meningitis showed significant decrease only in the serum. 4. In both groups of patients with tuberculous meningitis and aseptic meningitis, CRP values in the CSF were closely correlated to those of the serum(Pearson's r=0.25326 p<0. 035, Pearson's r=0.4520 p<0.0000 respectively) Considering that the content of protein was also significantly(p<0.000) elevated in the patients with tuberculous meningitis and that the CRP ratio(Qcrp) was also significantly(p<0.0035) elevated in comparison to the controls, the increased CRP in the CSF of tuberculous meningitis is probably due to an increased simple diffusion through the blood-CSF barrier resulted from increased serurn CRP and through impairrnent of blood-CSF barrier.