ArticleFrontiers in cellular and infection microbiology2022
10-Year Retrospective Review of the Etiologies for Meningitis With Elevated Adenosine Deaminase in Cerebrospinal Fluid: Etiologies Other Than TB.
Article in Frontiers in cellular and infection microbiology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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4 citing papers in PubMed, 13 citations in OpenAlex.
- A fatal posterior-fossa chloroma masquerading as tuberculous meningitis after peripartum BCR-ABL1 inhibitor cessation - a case report.Leukemia research reports · 2026Article
- Varicella-Zoster Virus Meningitis With Hypoglycorrhachia Mimicking Tuberculous Meningitis: A Case Report.Cureus · 2025Article
- Proteomic profiling of cerebrospinal fluid uncovers distinctive pathophysiological changes and potential biomarkers in pediatric tubercular meningitis.Frontiers in cellular and infection microbiology · 2025Article
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6 authors at 3 institutions in 1 country.
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Abstract
Purpose: An elevated adenosine deaminase (ADA) level in the cerebrospinal fluid (CSF) is considered a reliable marker of tuberculous meningitis (TBM). However, CSF-ADA levels can also be elevated in other diseases. We aimed to find the most common diagnosis of patients with elevated CSF-ADA levels for the last 10 years. Methods: We retrospectively investigated the diagnoses of all patients with elevated CSF-ADA (ADA ≥ 10 IU/L) levels between 2010 and 2019 at the Samsung Medical Center. Definite TBM was defined based on microbiological evidence. Clinical TBM was defined based on the brain imaging and response to the standard TB treatment. We compared the laboratory characteristics of the three most common diagnoses. Results: CSF-ADA levels were elevated in 137 (5.6%) of 2,600 patients. The most common diagnoses included hematologic malignancy (HM; n = 36, 26.2%), TBM (n = 26, 19.0%), and viral meningitis (VM; n = 25, 18.2%). CSF-ADA levels did not differ significantly between TBM [median (interquartile range (IQR)), 20.2 IU/L (13.8-29.3)] and HM [16.5 (12.8-24.0)]. However, CSF-ADA levels were lower in VM [14.0 (11.0-16.1)] than in TBM (p = 0.027). Lymphocyte-dominant pleocytosis was more common in VM [77.0% (70.8-81.5)] than in TBM [16.0 (3.0-51.0), p = 0.015] or HM [36.0 (10.0-72.0); p = 0.032]. Interestingly, the CSF characteristics of clinical TBM were similar to those of VM but not definite TBM. Conclusion: The most common diagnoses with elevated CSF-ADA levels were HM, followed by TBM and VM. Clinicians should carefully consider the differential diagnoses in patients with elevated CSF-ADA levels, especially those in the early stage of meningitis without microbiological evidence for TBM.
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