ADENOSINE DEAMINASE AS A DIAGNOSTIC MARKER FOR TUBERCULAR PLURAL EFFUSION: A COMPARATIVE ANALYSIS
Main Article Content
Keywords
ADA, Pleural fluid, Tuberculosis and Tubercular pleural effusion.
Abstract
Background: Tuberculosis is the single most frequent infectious cause of deaths worldwide and also the commonest cause of pleural effusion. The measurement of level of adenosine deaminase (ADA) enzyme in body fluids is a helpful diagnostic tool. The level of ADA elevates as the lymphocytic activity increases. The present study was carried out to assess the ADA activity in pleural fluid for early diagnosis and management of tubercular pleural effusion.
Objective: To determine the diagnostic value of ADA in differentiating tubercular and nontubercular pleural effusion based on sensitivity and specificity.
Materials and Methods: The present study was conducted on 56 tubercular pleural effusion patients and 54 non-tubercular pleural effusion patients who attended the OPD of Shri Guru Ram Rai Institute of Medical and Health Sciences, Dehradun. A structured proforma was used for documenting the history, symptoms and various biochemical investigations like glucose, protein
and ADA activity of these patients.
Result: The study suggested that ADA levels were significantly higher (p-value= < 0.0001) in cases as compared to controls. The sensitivity and specificity of ADA for the diagnosis of tubercular pleural effusion are 85.7% and 88.9% respectively.
Conclusion: ADA levels are noticeably raised in tubercular pleural effusion and showed gooddiag ostic accuracy. ADA estimation is simple, reliable, cost-effective and diagnostically useful investigation.
References
2.Modi SD, Agrawal AK, Bhake AS, Agrawal VR.Role of adenosine deaminase in pleural fluid in tubercular pleural effusion.J Datta Meghe Inst Med Sci Univ 2018;13:163-7.
3.Vorster MJ, Allwood BW, Diacon AH, Koegelenberg CF.Tuberculouspleural effusions: Advances and controversies. J Thorac Dis2015;7:981‑91.
4.Verea Hernando HR, Masa Jimenez JF, Dominguez Juncal L,Perez Garcia-Buela J, Martin Egaña MT, Fontan Bueso J.Meaning and diagnostic value of determining the lysozymelevel ofpleural fluid. Chest 1987;91(3):342–5.
5.Suleman A, Kamal M, Abbasi MA, Anwar SA, Khan H. Diagnostic utility of pleural fluid adenosine deaminase level in tuberculous pleural effusion. Journal of Ayub Medical CollegeAbbottabad. 2016 Jun 1;28(2):245-8.
6.Bielsa S, Palma R, Pardina M, EsquerdaA, Light RW, Porcel JM. Comparison of polymorphonuclear-and lymphocyte-rich tuberculous pleural effusions. Int J Tuber Lung Dis.2013 Jan 1;17(1):85-9.
7.Piras MA, Gakis C, Budroni M, Andreoni G. Adenosinedeaminaseactivity in pleural effusions: an aid to differentialdiagnosis. Br Med J 1978;2(6154):1751–2.
8.Rousta F, Sokouti M, Rouy SB, Parsay S. Diagnostic Value of Pleural Fluid Adenosine Deaminase In PatientswithPleural Tuberculosis. Journal of Genetic Engineering andBiotechnology Research. 2022 Nov 24;4(3):393-8.
9.Lee SJ, Kim HS, Lee SH, Lee TW, Lee HR, Cho YJ, Jeong YY, Kim HC, Lee JD, Hwang YS. Factors influencing pleural adenosine deaminase level in patients with tuberculous pleurisy. AmJ Med Sci. 2014 Nov;348(5):362-5. doi: 10.1097/MAJ.0000000000000260. PMID: 24762755.
10.Salam HM, Abdel-Hamid HM, Mostafa YM. Adenosine deaminase activity in serum and pleural fluid of patients with tuberculosis and those without tuberculosis. The Egyptian Journalof Chest Diseases and Tuberculosis. 2022 Apr 1;71(2):228.
11.Masood KI, Shahid S, Jabeen K, Farooqi J, Kerawala SR, Irfan M. Diagnostic accuracy of different cut-off values of adenosine deaminase levels in tuberculous pleural effusion. Journalof Pakistan Medical Association. 2023;73.
12.HJ, G.D., 2019. Utility of pleural fluid adenosine deaminase in diagnosing tubercular pleural effusion: a prospective observational study in a tertiary care hospital
13.Dave V, Patel SJ, Shah A. Pleural Fluid Adenosine Deaminase for Diagnosis of Tuberculous Pleural Effusion. Int J Res Med. 2018;7(2):41-9
14.Light RW. Pleural diseases. Current opinion in pulmonary medicine. 2003 Jul 1;9(4):251-3.
15.Baganha MF, Pêgo A, Lima MA, Gaspar EV, Cordeiro AR.Serum and pleural adenosine deaminase: correlation with lymphocytic populations. Chest. 1990 Mar 1;97(3):605-10.
16.Ahmed S, Fatema R, Saleh AA, Sattar M, Miah MR. Diagnostic significance of pleural fluid adenosine Deaminase activity in tuberculous pleurisy. Ibrahim Medical College journal.2011;5(1):1-5.
17.Darshini KP, Reena R, Nussrath A. Diagnostic utility of adenosine deaminase activity in tubercular pleural effusion. Journal of Evolution of Medical and Dental Sciences. 2013 Jun17;2(24):4358-63.
18.Valdés L, Álvarez D, San José E, Penela P, Valle JM, García-Pazos JM, Suárez J, Pose A. Tuberculous pleurisy: a study of 254 patients. Archives of internal medicine. 1998 Oct12;158(18):2017-21.
Article Sidebar
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
Anita Bisht
Tutor, Department of Biochemistry, Shri Ram Murti SmarkInstitute of Medical Sciences,
Bareilly, U.P.Email ID:[email protected]
Mohammad Shahrukh
Assistant Professor, Department of Biochemistry, Rohilkhand Medical College & Hospital,
Bareilly, U.P.Email ID:[email protected]
Sumita Sharma
Additional ProfessorDepartment of Biochemistry, AIIMS Bilaspur, Himachal Pradesh. EmailID: [email protected]
