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A nitrocellulose immunospot assay to enumerate cells secreting anti-BCG antibodies was evaluated in the diagnosis of tuberculous meningitis.Among 25 Chinese patients with this disease diagnosed on clinical and cerebrospinal fluid(CSF)criteria,24 had anti-BCG IgG antibody secreting cells in CSF,at a median value of 56 per 10 4 CSF cells.Among 6 patients examined within one week,5 had antibody secreting cells in CSF,and all 19 patients examined 2-8 weeks after onset had such cells in CSF.Blood examined from 5 patients contained anti-BCG IgG or IgM antibody secreting cells,but usually at much lower numbers than in corresponding CSF, indicating that the specific antibody response is largely confined to CSF. Anti-BCG antibodies measured in parallel by ELISA were slightly raised in CSF in only 1 of the 6 patients examined within a week,whereas a good correspondence was seen between numbers of antibody secreting cells and antibody concentrations from the second week onwards.Detection of anti-BCG IgG antibody secreting cells has higher sensitivity and specificity than ELISA measurement of anti-BCG IgG antibodies,and represents a new,useful method for the early diagnosis of tuberculous meningitis. |
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meningitis
meningitis,CSF findings in
meningitis,TB
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