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Adenosine deaminase activity in tuberculous pleural effusions: a diagnostic test
W F Strankinga1, J J Nauta, J P Straub
1Department of Pulmonology and Tuberculosis, Academic Hospital, Free University, Amsterdam, The Netherlands.
Tubercle
|June 1, 1987
Summary
Adenosine deaminase (ADA) activity in pleural fluid is a sensitive marker for diagnosing tuberculous pleurisy. Elevated ADA levels, particularly above 53 U/l, show high accuracy in identifying tuberculosis.
Area of Science:
- Pulmonology
- Infectious Diseases
- Biochemistry
Background:
- Pleural effusions are common clinical findings with diverse causes.
- Accurate diagnosis of tuberculous pleurisy is crucial for timely treatment.
- Adenosine deaminase (ADA) is an enzyme involved in lymphocyte metabolism.
Purpose of the Study:
- To evaluate the diagnostic utility of adenosine deaminase (ADA) activity in pleural effusions for tuberculous pleurisy.
- To compare ADA levels in tuberculous pleurisy with other pleural effusion etiologies.
Main Methods:
- Adenosine deaminase (ADA) activity was measured in pleural effusion samples.
- Patients included 10 with tuberculous pleurisy and 76 with other pleural effusion causes.
- Statistical analysis compared ADA levels across different etiological groups.
Main Results:
- Significantly higher ADA activity was observed in patients with tuberculous pleurisy compared to most other causes.
- ADA levels in tuberculous pleurisy were comparable to those in empyema.
- A reference limit of >53 U/l demonstrated 100% sensitivity and 87% specificity for tuberculosis.
Conclusions:
- Pleural fluid ADA activity is a highly sensitive biomarker for diagnosing tuberculous pleurisy.
- ADA testing offers a valuable, non-invasive tool for differentiating tuberculous pleurisy.
- The test shows excellent diagnostic performance when using an appropriate reference value.