Diagnostic Value Of Cerebrospinal Fluid LAM Antibody Detection On Tuberculous Meningitis

Tuberculous meningitis (tuberculous meningitis,TBM) is caused byMycobacterium tuberculosis (mycobacterium tuberculosis,Mtb) which isnon-suppurative meningitis inflammatory disease, and is also the most common typeof central nervous system tuberculosis. Currently, the incidence of tuberculousmeningitis is rising on a global scale, whose mortality rate is about20-41%[9~11].The diagnosis of tuberculous meningitis is very difficult, in clinically, it is easily bemisdiagnosed as viral meningitis, cryptococcal meningitis and delayed treatment.With the development of immunology, it has found many cytokines which play a veryimportant role in the development of tuberculous meningitis disease [12,13]. The Mtbantibodies are protein which compound in the stimulation of antigens in the localorganization after the body infected by the Mtb. Lipoarabinomannan(LAM) is themain structure of the Mtb cell wall lipopolysaccharide, which is the surface antigen ofthe Mtb cell wall, whose specificity and immunogenicity is strong. LAM in infectedhosts often cause strong antibody response, which can effectively stimulate the bodyto produce IgG type LAM antibody. In this article, by detect cerebrospinal fluidLAM-IgG, I assessed its clinical value in the early diagnosis of tuberculousmeningitis.Purpose Exploring the value of lipoarabinomannan antibody (LAM-IgG) incerebrospinal fluid(CSF) for the diagnosis of tuberculous meningitis(TBM).Method Uusing enzyme-linked immunosorbent assay(ELISA) to detectTBM group(46cases), viral meningitis group(10cases), purulent meningitis group(12cases) and normal control group(22cases) of the CSF LAM-IgG expression levels. Results The average expression level of LAM-IgG in CSF in patients withTBM was0.11±0.027ng/ml, which was significantly higher thanviralmeningitis(0.088±0.008ng/ml), purulent meningitis(0.09±0.015ng/ml) andnormal controls(0.078±0.016), the difference was statistically significant((P=0.006,P=0.007, P=0.000). The difference between viral meningitis, purulent meningitisand normal controls was not statistically significant(P=0.243,P=0.140,P=0.840).Conclusion Detection of LAM-IgG in CSF has important clinical value ofearly diagnosis and differential diagnosis of TBM.