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Updated: Jan 25, 2026

Local Anesthetic Thoracoscopy for Undiagnosed Pleural Effusion
Published on: November 10, 2023
Lymphocytic Pleural Effusion and an Enzyme Involved in Purine Metabolism: A Tertiary Care Experience in Karachi,
Rashid Naseem Khan1, Syed Ijlal Ahmed2, Syedhh Fatima Kausar1
1Internal Medicine, Darul Sehat Hospital, Karachi, PAK.
Background:
The levels of adenosine deaminase (ADA) are increased in tubercular pleural effusion and its determination has acquired popularity as a diagnostic test which is inexpensive and is readily accessible. Pleural fluid ADA showed sensitivity (86.36%), specificity (61.54%), diagnostic accuracy (80.70%), positive predictive value (88.37%), and negative predictive value (82.42%) confirmed by pleural biopsy as a gold standard.
Methodology:
Our study was a prospective cross-sectional study which was conducted for three years at a tertiary care center in Karachi, Pakistan. The data were collected and analyzed using IBM statistics SPSS vs21.
Results:
There were 52 patients included in our study. Twenty one were males and thirty one were females. Most patients presented with shortness of breath. There was a significant association found between raised ADA levels and pulmonary tuberculosis (p < 0.05). The ADA levels are 12 times more likely to be raised in tubercular pleural effusion.
Conclusion:
The ADA level is an important marker for diagnosis of pulmonary tuberculosis in lymphocytic pleural effusion. It is a convenient and an inexpensive method. The ADA levels assessment is economical when compared to other diagnostic methods.
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