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Abstract Details

Diagnostic and Prognostic Significance of CSF-CPK in Meningitis
Infectious Disease
Infectious Disease Posters (7:00 AM-5:00 PM)
094
To measure the CSF and serum CPK values in pyogenic, tubercular and viral meningitis and ascertain its association with severity of disease.

Creatinine phosphokinase (CPK), an enzyme involved in the phosphorylation of the creatinine with ATP from ADP and creatinine phosphate is markedly elevated in meningitis of varied etiology. Out of CPK isoenzymes, CPK-BB (Brain type) was found to be more specifically raised in infections of central nervous system. The liberation of CPK-BB from the brain tissue and its penetration into the intercellular fluid and then into the CSF was related to the functional structural changes in the cellular membranes of the brain in meningitis.
A cross section study with a sample size of 40 patients was carried out, 20 of which were controls. For the study group, clinically evident cases were selected, lumbar puncture was done and CSF was sent for cytology/biochemical analysis including CPK. Serum CPK samples were sent simultaneously. Asymtomatic patients who were posted for surgery under spinal anaesthesia were taken as controls. Their CSF and serum CPK samples were sent in a similar fashion.
Serum CPK values in all the three groups of meningitis were not elevated corresponding to CSF-CPK. CSF-CPK values were elevated more in cases of pyogenic meningitis than tubercular and viral meningitis. The CSF-CPK had a direct relationship with the deteriorating level of consciousness and mortality.
It can be concluded that the CSF-CPK is elevated in all cases of meningitis. It was not possible to differentiate the type of meningitis on the basis of enzymatic activity in any of them. However it was possible to assess the degree of brain damage and to predict prognosis because higher basal activity of the enzyme was associated with poor prognosis. It also had a direct relationship with the level of consciousness of the patient and mortality.
Authors/Disclosures
Raghav Kapoor, Sr., MD, MBBS
PRESENTER 		Dr. Kapoor has nothing to disclose.
Bharat Rastogi, MD Dr. Rastogi has nothing to disclose.