Rinsho Shinkeigaku (Clinical Neurology)

Brief Clinical Note

Interferon-gamma release assay in cerebrospinal fluid of a patient with tuberculous meningitis: A case report

Ayumi Uchibori, M.D.1), Tai Miyazaki, M.D.1), Haruyuki Ariga, M.D.2) and Atsuro Chiba, M.D.1)

1)Department of Internal Medicine and Neurology, School of Medicine, Kyorin University
2)Department of Respiratory Medicine, National Hospital Organization, Tokyo National Hospital

Interferon-gamma release assay (IGRA) using specific tuberculous antigens is a rapid, specific and sensitive method for the detection of tuberculous infection, and usually done in peripheral blood sample. We examined IGRA in cerebrospinal fluid (CSF) in a patient strongly suspected of having tuberculous meningitis. A 53-year old woman had a month history of headache and fever with meningeal sign. Routine systemic bacterial, tuberculous and viral analyses all resulted in negative study except for increase of adenosine deaminase in CSF. Neither of antibacterial or antiviral treatments were effective, but she was successfully treated with antituberculous agents. In IGRA, the interferon-gamma concentration in her CSF was high in the background level and increased further after the antigen stimulation, suggesting theoretically that tuberculous antigen-specific T cells were presented in her CSF. IGRA of CSF in combination with peripheral blood-IGRA could be a useful and rapid method for diagnosing active tuberculosis in the central nervous system.
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(CLINICA NEUROL, 49: 428|431, 2009)
key words: tuberculous meningitis, interferon-gamma release assay

(Received: 30-Jul-08)