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Edwin Shuttleworth, MD; Norman Allen, MD

Arch Neurol. 1980;37(11):684-687.

Abstract
• The clinical value of CSF β-glucuronidase assay in the differential diagnosis of chronic meningitis has been investigated over the past 20 years. Significant (P <.001), often marked, elevation of the enzyme level was found in the first sample submitted in 29 of 30 cases of neoplastic meningitis, irrespective of treatment (mean, 324 units), and in 12 of 14 untreated cases with meningeal lymphoma (mean, 174 units). On the other hand, untreated patients with chronic meningitis of other etiologies had significantly lower levels of enzyme elevation, eg, leukemic meningitis (mean, 46 units), fungal meningitis (mean, 41 units), and tuberculous meningitis (mean, 79 units). In the few cases of chronic meningitis studied during appropriate therapy, a tendency toward a decrease in enzyme activity was noted, thus offering further diagnostic support. In our opinion, the finding of a marked elevation of β-glucuronidase activity in a patient with chronic meningitis is presumptive evidence of neoplastic etiology.

Author Affiliations
From the Division of Neurology, Department of Medicine, Ohio State University Hospitals, Columbus.

Footnotes
Accepted for publication Dec 26, 1979.

Read in part before the 103rd annual meeting of the American Neurological Association, Washington, DC, Sept 23, 1978.

Reprint requests to 466 W 10th Ave, Columbus, OH 43210 (Dr Shuttleworth).

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