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Adenosine deaminase activity in pleural fluid--a diagnostic test of tuberculous pleural effusion
R Prasad1, R P Tripathi, P K Mukerji
1Department of Tuberculosis, KG's Medical College, Lucknow and Central Drug Research Institute.
Abstract:
Adenosine deaminase (ADA) activity in pleural fluids was studied in 47 patients with pleural effusion of different etiology. Patients were divided into two groups: Group I - Tuberculous pleural effusion (21 patients): Group II - Non tuberculous effusion (26 patients) and these included malignant pleural effusion (9 cases), synpneumonic pleural effusion (9 cases) and transudative pleural effusion (8 cases). The mean ADA activity was 64.67 IU/L +/- 21.68 in group I and 6.99 +/- 3.69 in Group II. Increased mean pleural fluid ADA activity in tuberculous pleural effusion was highly significant (p < 0.001) when compared with pleural effusion of non-tuberculous etiology. Based on lowest value of ADA activity found in tuberculous pleural effusion (30 IU/L), the test has a sensitivity and specificity of 1.
Insights
Adenosine deaminase (ADA) activity in pleural fluid is a strong indicator for diagnosing tuberculous pleural effusion. Elevated ADA levels significantly differentiate tuberculosis from other pleural effusion types.
Area of Science:
- Pulmonology
- Infectious Diseases
- Biochemistry
Background:
- Pleural effusion diagnosis can be challenging.
- Tuberculous pleural effusion requires timely and accurate identification.
- Adenosine deaminase (ADA) is an enzyme implicated in lymphocyte activation.
Purpose of the Study:
- To evaluate the diagnostic utility of adenosine deaminase (ADA) activity in pleural fluid.
- To differentiate tuberculous pleural effusion from non-tuberculous effusions.
Main Methods:
- Analyzed ADA activity in pleural fluid samples from 47 patients.
- Grouped patients into tuberculous pleural effusion (21) and non-tuberculous effusion (26) categories.
- Compared mean ADA levels between groups using statistical analysis.
Main Results:
- Mean ADA activity was significantly higher in tuberculous pleural effusion (64.67 IU/L) compared to non-tuberculous effusion (6.99 IU/L) (p < 0.001).
- A threshold of 30 IU/L for pleural fluid ADA activity demonstrated 100% sensitivity and specificity in this cohort.
Conclusions:
- Elevated pleural fluid ADA activity is a highly significant marker for tuberculous pleural effusion.
- ADA assay in pleural fluid offers a sensitive and specific diagnostic tool for tuberculosis-related effusions.