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Adenylate kinase values in cerebrospinal fluid as a marker to predict neurological outcome in children with meningitis
Author(s)
Carlini, Sophia Magdalena
Date Issued
1997
Type
Thesis
Publisher
Cape Technikon
Abstract
Meningitis in children is a common and serious disease. Bacterial and tuberculous meningitis often lead to neurological complications. A sensitive marker to predict brain damage in children with meningitis could be of great importance. Frithz F et aI, 1982 suggested that increased adenylate kinase values could indeed be used as a marker for brain damage.
Adenylate kinase (AK) is an enzyme present in brain tissue. Low concentrations are present in
normal cerebrospinal fluid (CSF) « 1 uti). Increased concentrations were found in cases of
ischemic brain damage (Frithz et aI, 1982), malignant brain tumours (Ronquist G et aI, 1977) and
bacterial meningitis. As AK has a low molecular weight (22,00 Daltons), in comparison to other
kinases (40,000 Daltons) it is one of the first enzymes that can be detected in the CSF after brain
damage and it can thus be used as a reliable marker for brain cell damage.
The aim of this study was to quantify the AK values in CSF of children with bacterial and
tuberculous meningitis and to evaluate their use to predict the neurological outcome in children with
bacterial and tuberculous meningitis.
Eighty eight children with tuberculous meningitis (TBM) and thirty three children with bacterial
meningitis were included in the study. Sixty children with suspected meningitis but who were later
diagnosed with urinary tract infections, gasto-enteritis, bronchitis, febrile convulsions or other non-neurological
infections were used as controls.
The results showed raised AK values in the CSF of children with bacterial- and TB meningitis.
There was a statistically significant difference of AK values between stage III and II TBM AK values
in patients at week 1 after diagnosis (p=0,03). There was also a statistically significant correlation
between CSF AK values and lactate concentrations (P=0,001) which reflected hypoxic brain
metabolism.
Although AK values did not always correlate directly with the patients’ clinical outcome, there is proof that increased AK values in CSF can be used to predict neurological outcome.
Adenylate kinase (AK) is an enzyme present in brain tissue. Low concentrations are present in
normal cerebrospinal fluid (CSF) « 1 uti). Increased concentrations were found in cases of
ischemic brain damage (Frithz et aI, 1982), malignant brain tumours (Ronquist G et aI, 1977) and
bacterial meningitis. As AK has a low molecular weight (22,00 Daltons), in comparison to other
kinases (40,000 Daltons) it is one of the first enzymes that can be detected in the CSF after brain
damage and it can thus be used as a reliable marker for brain cell damage.
The aim of this study was to quantify the AK values in CSF of children with bacterial and
tuberculous meningitis and to evaluate their use to predict the neurological outcome in children with
bacterial and tuberculous meningitis.
Eighty eight children with tuberculous meningitis (TBM) and thirty three children with bacterial
meningitis were included in the study. Sixty children with suspected meningitis but who were later
diagnosed with urinary tract infections, gasto-enteritis, bronchitis, febrile convulsions or other non-neurological
infections were used as controls.
The results showed raised AK values in the CSF of children with bacterial- and TB meningitis.
There was a statistically significant difference of AK values between stage III and II TBM AK values
in patients at week 1 after diagnosis (p=0,03). There was also a statistically significant correlation
between CSF AK values and lactate concentrations (P=0,001) which reflected hypoxic brain
metabolism.
Although AK values did not always correlate directly with the patients’ clinical outcome, there is proof that increased AK values in CSF can be used to predict neurological outcome.
Additional information
Thesis (Master's Diploma(Technology (Medical Technology))-- Cape Technikon, 1997
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