Quantitative levels of fibrin(ogen) related materials in cerebrospinal fluid in patients with bacterial meningitis and other conditions

Abstract

We assumed that fibrin deposits and subsequent lysis within cerebrospinal fluid may occur in the various inflammatory disorders involving meninges. Therefore, we measured fibrin(ogen) related materials in cerebrospinal fluid of 118 patients with 21 bacterial meningitis, 22 aseptic meningitis, 75 non-meningitis associated with infectious febrile conditions and other neurologic conditions. Fibrin(ogen) related materials were quantitated as immunological components (D and E) of fibrin(ogen), which react with anti-D and anti-E using automated latex photometric immunoassay. When compared to aseptic meningitis group (mean; D=7.3, E=1.4ng/ml), the levels of D and E fibrin(ogen) related materials in cerebrospinal fluid were increased to highly significant levels in the bacterial meningitis group including tuberculous meningitis (mean; D=36.4, E=6.4ng/ml) (p<0.05). D/E ratio was also significantly increased in tuberculous meningitis, compared to other groups (P<0.001). D and E levels in cerebrospinal fluid were significantly correlated with white blood cell count, polymorphonuclear cells (%) and protein concentration, while the values were in inverse correlation with mononuclear cells (%) and glucose concentration. This data strongly suggest clinical usefulness of the measurement of fibrin(ogen) related materials in cerebrospinal fluid for the differential diagnosis of meningitis.