Importance of Adenosine Deaminase Estimation in Diagnosis of Tuberculous Pleural Effusion
ADA estimation in TB
Keywords:
Tuberculosis, ADA, Pleural effusionAbstract
Aim & Objective: To evaluate the usefulness of estimation of ADA (Adenosine deaminase) activity for etiological diagnosis of pleural effusion & to study the level of pleural fluid ADA in tuberculous & nontuberculous pleural effusion & establish cutoff limit of ADA activity. Materials & Methods: Present study was conducted in pathology department Pandit Dindayal Upadhyay Medical College Rajkot during year July 2005 to September 2007 for which we have taken 100 patients of all ages & either sex admitted in various medical wards, T.B. ward and O.P.D. Spectrophotometric method was used for ADA estimation. Results: The present study was carried out in 100 patients out of which 78 patients were of tuberculous pleural effusion & 22 cases were of Non-TB pleural effusion. There was minor difference in male & female Pleural Fluid (Both TB & Non TB) Mean ADA Level. Most of Tuberculous Effusion was in Range of 40-60 U/L ADA level (64 Pts) while Non Tuberculous effusion was between 16-20 U/L of ADA level (14 Pts). At level of 35 U/L of cut-off limit of ADA in pleural fluid sensitivity & specificity would be 94.7% & 72.7% respectively. Conclusion: The study concluded that estimation of ADA in Pleural Fluid is simple, rapid & less expensive laboratory investigation for diagnosis of tuberculous pleural effusion when diagnosis is uncertain by other investigation & it has valuable role as an adjuvant investigation to other diagnostic investigation of Tuberculosis.
References
3. SK Verma, AL Dubey, PA Singh, et al. Adenosine deaminase level in tuberculous pleural effusion. Lung India. 2008 Jul-Sep;25(3);109-110.
4. Rajendra Prasad-ADA in pleural fluid Idian journal of chest disease.1992;123-26.
5. Niwa Y ,Kishimoto H, Shimokata K. Carcinomataus and tuberculous pleural effusion. Chest,1985; 85; 351-55.
6. Guisti G, Galanti B. Adenosine deaminase. Calorimetric method. In methods of enzymatic analysis. 5th edition, edited by: bergmeyr HU, Weinheim(germany), Verlag Chemic,315-23.
7. Rodriquiz EP, Ferrando C, Flonder J, et al. ADA in pleural effusion. Chest. 1992;102:325.
8. Jindal SK. ADA in pleural effusion. J Assoc Physician India. 1993;41:41–620.
9. Ribera E, MartÃnez Vázquez JM, Ocana I, et al. Gamma interferon and adenosine deaminase in pleuritis. Med Clin 1990;94:364–67.
10. Valdes L, San Jose E, Alvarez D, et al. Diagnosis of tuberculous pleuresy using the biologic parameters adenosine deaminase, lysozime and interferon gamma. Chest 1993;103:458–65.
11. Muranhisi H, Nakashima M, Hirano H, et al. Simultaneous measurements of adenosine deaminase activity and tuberculostearic acid in pleural effusion for the diagnosis of tuberculous pleuritis. Intern Med 1992;31:752–55.
