Table 1 Summary of serum and cerebrospinal fluid investigations
From: Case report: meningitis as a presenting feature of anti-NMDA receptor encephalitis
SERUM | CEREBROSPINAL FLUID (Three lumbar punctures performed on admission days 1, 13 & 23) (reference range) | |||||
|---|---|---|---|---|---|---|
Infective | Autoimmune | Tumour markers (reference range) | ||||
Admission day | 1 | 13 | 23 | |||
Negative for: HIV antigen/antibody Hepatitis C antibody Anti-treponemal IgG CMV IgM and IgG EBV IgM Leptospirosis IgM Borrelia antibody Cryptococcal antigen Blood cultures | Negative for: Anti-VGKC MPO & PR3-ANCA C3 and C4 ANA Anti-CCP Anti-Ro Anti-La Anti-Smith Anti-RNP Anti-Scl-70 Anti-Jo | LDH: 265 (125–220 units/liter) CA-125: 8 (0–35 units/mL) β-HCG: < 1 (< 5 m-international units/mL) AFP: < 2 (< 6 ng/mL) No paraproteins Normal immunoglobulin levels. | Opening pressure (cm H20) (5–20) | 32 | 17 | Not available |
White cell count (× 106/L) (< 5) | 172 (100% lymphocytes) | 85 (Differential not available) | 143 (100% lymphocytes) | |||
Red cell count (×106/L) (0) | 35 | 6 | 0 | |||
Protein (g/L) (0.15–0.60) | 0.77 | 1.07 | 0.32 | |||
Glucose(serum glucose) (g/L) (60–80% of serum) | 2.3 (no serum) | 2.5 (10·5) | 3.8 (6·1) | |||
Cryptococcal antigen | – | Negative | – | |||
ANCA | – | Negative | – | |||
Microscopy | No organisms seen (all three samples) | |||||
Microbiology (by PCR) | Negative for: Bacteria: H. influenza, S. pneumoniae, N. meningitidis (all samples) Virus: enterovirus, HSV 1 & 2, VZV, parechovirus (all samples) | |||||
Culture and sensitivity | No growth, No mycobacteria (all samples) | |||||
Cytology | No malignant cells detected (all samples) | |||||