Diagnostic Utility Of Pleural Fluid Adenosine Deaminase Level In Tuberculous Pleural Effusion

Area of Science:

• Medical Diagnostics
• Infectious Diseases
• Pulmonology

Background:

• Tuberculosis (TB) diagnosis and management are crucial for reducing disease burden.
• Pakistan faces a high TB burden, necessitating effective diagnostic methods.
• Existing TB diagnostic tests have limitations.

Purpose of the Study:

• To validate pleural fluid adenosine deaminase (ADA) levels for diagnosing tuberculous pleural effusion.
• To assess the diagnostic accuracy of ADA in pleural fluid.

Main Methods:

• A cross-sectional validation study was conducted.
• 160 patients with exudative lymphocytic pleural effusions were enrolled.
• Pleural fluid ADA levels were measured and compared with pleural biopsy/histopathology results.

Main Results:

• The mean pleural fluid ADA level was 52.18±1.98 U/L.
• ADA levels were significantly higher in patients with tuberculous pleural effusion (52.16±2.4 U/L) compared to non-TB cases (38.6±3.14 U/L) (p<0.05).
• Sensitivity, specificity, PPV, and NPV of pleural fluid ADA were 88.88%, 77.04%, 86.28%, and 81.04%, respectively.

Conclusions:

• Pleural fluid ADA levels can serve as a valuable surrogate marker for diagnosing tuberculous pleural effusion.
• ADA testing is particularly useful when pleural biopsy is not feasible.
• The study supports the utility of ADA levels in TB diagnosis, despite variations in reported accuracy.