Cerebrospinal fluid hepatocyte growth factor level in meningitis

Background and Purpose: Hepatocyte growth factor (HGF) is a multifunctional cytokine that has been found to be elevated in tuberculous and bacterial meningitis, but no evaluation has been undertaken of its usefulness in identifying various forms of aseptic meningitis. Methods: In a retrospective study, the levels of HGF in the cerebrospinal fluid of 65 patients were measured prior to treatment. The association of HGF with non-infectious diseases and clinically or microbiologically proven bacterial, tuberculous, viral, fungal and parasitic meningitis was observed, along with its relation to other parameters of the cerebrospinal fluid. Results: Forty six of the 65 patients (71%) were diagnosed as having meningitis. Cerebospinal fluid HGF level was significantly elevated in patients with meningitis compared with patients with non-infectious diseases (1501 vs 578 pg/mL; Mann-Whitney U test, p=0.001). The highest HGF level was found in bacterial meningitis (2699 pg/mL), followed by tuberculous meningitis (1540 pg/mL), viral meningitis (1431 pg/mL), fungal meningitis (714 pg/mL) and parasitic meningitis (174 pg/mL). There was no association between HGF level and other parameters of the cerebrospinal fluid (Pearson's correlation test). Conclusion: Cerebrospinal fluid HGF may offer additional information in the classification of meningitis. This may assist in patient management when no pathogen is cultured from the cerebrospinal fluid and when other parameters of the cerebrospinal fluid demonstrate equivocal results.