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[Adenosine deaminase in typhoid fever and other febrile diseases]
V Casanueva1, X Cid, G Cavicchioli
1Departamento de Pediatría, Facultad de Medicina, Universidad de Concepción.
Insights
Serum adenosine deaminase (ADA) activity is significantly elevated in typhoid fever patients. This enzyme test shows high sensitivity and specificity, aiding in the early diagnosis of typhoid fever.
Area of Science:
- Biochemistry
- Clinical Diagnostics
- Infectious Diseases
Context:
- Typhoid fever, a serious bacterial infection, poses a significant global health challenge.
- Accurate and timely diagnosis is crucial for effective treatment and public health management.
- Existing diagnostic methods can have limitations in sensitivity, specificity, or accessibility.
Purpose:
- To evaluate the diagnostic utility of serum adenosine deaminase (ADA) activity for typhoid fever.
- To compare ADA levels in typhoid fever patients with those in various control groups.
- To determine the sensitivity and specificity of ADA activity as a diagnostic marker.
Summary:
- Serum ADA activity was measured in 246 children and 46 adults using Giusti's technique.
- Significantly higher ADA levels were observed in typhoid fever patients compared to healthy controls and those with other febrile illnesses (p < 0.0001).
- A cut-off of 80 U/I yielded 91.8% sensitivity and 91.4% specificity for typhoid fever diagnosis.
Impact:
- Elevated serum ADA activity serves as a valuable biochemical marker for typhoid fever.
- This assay offers a promising preliminary diagnostic tool, particularly in resource-limited settings.
- The findings support the integration of ADA testing into the diagnostic workup for suspected typhoid fever.
Abstract:
The contribution of serum adenosine deaminase (ADA) activity to the diagnosis of typhoid fever was assessed in 246 children and in 46 adults, by Giusti's original technique. Children included otherwise healthy patients admitted for elective surgical conditions or under follow up for epilepsy which were considered to be a control group (n: 81), presumptive viral diseases (n: 31), miscellaneous febrile diseases except for typhoid fever (n: 41), different kinds of bacteremia (n: 6), diarrhea due to Salmonella typhimurium (n: 14), viral hepatitis (n: 24), and culture proven typhoid fever (n: 49). Adult's group included 39 healthy controls and 7 patients with culture proven typhoid fever. Among children mean ADA activity was as follows: control group 28 +/- 7.8, viral disease 35.3 +/- 13.1, miscellaneous febrile disease 36.1 +/- 15.6, bacteremia group: 30.3 +/- 10.3, salmonellosis group 51.6 +/- 9, hepatitis group 68.3 +/- 34.5, typhoid fever group 124.4 +/- 40.8 U/I 37 degrees C. Among adults, values were 18.4 +/- 7.5 for controls and 112.8 +/- 19.2 U/I 37 degrees C in typhoid fever patients. In both adults and children ADA activity was significantly higher in the typhoid fever group (p < 0.0001). Untreated typhoid fever patients had their higher ADA activity between 10th and 15th day of illness. When ADA cut point was set at 80 U/I, sensitivity of the test was 91.8% and specificity was 91.4% as a preliminary clue to the recognition of typhoid fever.