Evaluation of Lionex TB kits and mycobacterial antigens for IgG and IgA detection in cerebrospinal fluid from tuberculosis meningitis patients

Mem Inst Oswaldo Cruz. 2010 Aug;105(5):722-8. doi: 10.1590/s0074-02762010000500022.


To evaluate commercial Lionex TB together with four antigens of Mycobacterium tuberculosis (MPT-64, MT10.3, 16 kDa and 38 kDa) for IgG and IgA cerebrospinal fluid (CSF) detection in the diagnosis of tuberculosis meningitis (TBM) with CSF negative acid-fast bacilli staining, 19 cases of TBM, 64 cases of other infectious meningoencephalitis and 73 cases of other neurological disorders were tested by enzyme linked immunosorbent assay. IgA-MPT-64 and IgG Lionex showed the highest sensitivities, specificities, positive predictive value and negative predictive value (63.2%, 47.4%; 95%, 93.7%; 40%, 98% and 28.4%, 97.1%, respectively). However, while grey zone was 12.7% and 6%, respectively, lowering sensitivity but maintains high specificity (>or= 95%). High protein concentration in CSF was associated with antibody positivity CSF/HIV+ which did not influence the sensitivity of both tests. To our knowledge, this is the first description of IgA-MPT-64 and IgG Lionex antibodies in CSF-TBM and, although there is good specificity, adjustments are needed based on antigen composition to enhance sensitivity.

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antibodies, Bacterial / cerebrospinal fluid*
  • Antigens, Bacterial*
  • Enzyme-Linked Immunosorbent Assay
  • Humans
  • Immunoglobulin A / cerebrospinal fluid*
  • Immunoglobulin G / cerebrospinal fluid*
  • Mycobacterium tuberculosis / immunology*
  • Mycobacterium tuberculosis / isolation & purification
  • Predictive Value of Tests
  • Reagent Kits, Diagnostic
  • Sensitivity and Specificity
  • Tuberculosis, Meningeal / cerebrospinal fluid
  • Tuberculosis, Meningeal / diagnosis*
  • Tuberculosis, Meningeal / immunology


  • Antibodies, Bacterial
  • Antigens, Bacterial
  • Immunoglobulin A
  • Immunoglobulin G
  • Reagent Kits, Diagnostic