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Aims of MHSR Journal

• To serve as an important medium for the publication of original research in the field of medical science and health research, thus filling gaps in health knowledge for effective utilization of research findings
• To impart current medical knowledge and updated scientific information obtained from research to health professionals for better and appropriate health care management
• To disseminate recent basic, applied and social research findings among health personnel of different strata for enhancing worldwide health development

Archives   2006

Myanmar   Health   Sciences   Research   Journal

Volume   18,  Number   1

TITLE:   Diagnostic significance of fibrin(-ogen) degradation products in cerebrospinal fluid in childhood meningitis.
AUTHOR:   Ne Win; Khine-Hla Myint ; Thein Thein Myint; Than Nu Shwe; Aye Maung Han; Aye Aye Lwin; Minn Minn Myint Thu; Tin Htar Nwe
SOURCE:   Myanmar Health Sciences Research Journal. 2006; 18(1): 6-12
ABSTRACT:   Fibrin(-ogen) degradation products (FDP) was determined in cerebrospinal fluid (CSF) of 106 children suffering from meningitis (35 tuberculous, 37 pyogenic, and 34 non-bacterial meningitis) by using a locally developed test kit (DMR-FDP test kit). Generally diagnosis of different meningitis is made clinically, supported by routine examination of CSF (CSF-RE). The sensitivity of the test kit is 2 µg/ml fibrinogen equivalent. FDP content is determined semi-quantitatively by the doubling dilution of CSF and described as 0, 2, 4, 8, 16, 32, 64, 128, 256, and 512 µg/ml. Overall FDP content in CSF was ranging from 0-512 µg/ml. It varied with the type of meningitis: 0-8 µg/ml in non-bacterial meningitis, and ≥16 µg/ml in bacterial meningitis. CSF-FDP content was always ≤8 µg/ml in all of non-bacterial meningitis cases (34/34; 100%). In 35 TBM cases, 34 cases have 16-64 µg/ml, 1 case 128 µg/ml. In 37 pyogenic meningitis cases, 10 have 64 µg/ml and 27 have ≥128 µg/ml. Statistically, CSF-FDP level of 0-8 µg/ml has 100% sensitivity for non-bacterial meningitis; 16-64 µg/ml has 97.1% sensitivity for TB meningitis; and ≥128 µg/ml has 72.9% sensitivity for pyogenic meningitis. This study could define a cut-off point: CSF-FDP content, >8 µg/ml for bacterial meningitis and ≤8 µg/ml for non-bacterial meningitis and could also differentiate a meningitis case into different types: (i) nonbacterial meningitis when CSF-FDP ≤8 µg/ml and bacterial when ≥16µg/ml, (ii) tuberculous when 16-64 µg/ml, and (iii) pyogenic meningitis when ≥128 µg/ml. In conclusion, determination of FDP content in CSF by DMR-FDP test kit greatly facilitates the differential diagnoses of meningitis in children and it will be of great benefit to the clinicians, particularly at the health centers where and/or when laboratory facilities for CSF-RE are inefficient. The CSF-FDP should be measured routinely in children with meningitis and is suggested to be included in CSF-RE as an additional biochemical parameter to other conventional tests.
SUBJECT HEADINGS:   Fibrin Fibrinogen Degradation Products. Meningitis. Cerebrospinal Fluid.
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