Avaliação da adenosina desaminase no diagnóstico da tuberculose pleural: uma metanálise brasileira

Morisson, Patrizio; Neves, Denise Duprat

doi:10.1590/s1806-37132008000400006

Cited by 43 publications

(6 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In Brazil, TB has an initial presentation as a pleural disease in about 9% of adults and is the main cause of pleural effusion, corresponding to over 50% of cases [10,11]. In this study, we evaluated the role of a real-time PCR assay for the IS 6110 sequence of M. tuberculosis in pleural fluid specimens to evaluate the efficiency and practicality of the test for diagnosing pleural TB.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of real-time PCR of patient pleural effusion for diagnosis of tuberculosis

et al. 2011

View full text Add to dashboard Cite

BackgroundPleural tuberculosis (TB) diagnosis often requires invasive procedures such as pleural biopsy. The aim of this study was to evaluate the role of real-time polymerase chain reaction (PCR) for the IS6110 sequence of M. tuberculosis in pleural fluid specimens as a rapid and non-invasive test for pleural TB diagnosis.FindingsFor this cross-sectional study, 150 consecutive patients with pleural effusion diagnosed by chest radiography, who were referred for diagnostic thoracocentesis and pleural biopsy and met eligibility criteria, had a pleural fluid specimen submitted for real-time PCR testing. Overall, 98 patients had pleural TB and 52 had pleural effusion secondary to other disease. TB diagnosis was obtained using acid-fast bacilli (AFB) smear or culture for mycobacteria and/or histopathologic examination in 94 cases and by clinical findings in 4 cases. Sensitivity, specificity, positive and negative predictive values of PCR testing for pleural TB diagnosis were 42.8% (95% CI 38.4 - 44.8), 94.2% (95% CI 85.8 - 98.0), 93.3% (95% CI 83.6 - 97.7), and 48.5% (95% CI 44.2 - 50.4), respectively. The real-time PCR test improved TB detection from 30.6% to 42.9% when compared to AFB smear and culture methods performed on pleural fluid specimens, although the best sensitivity was achieved by combining the results of culture and histopathology of pleural tissue specimens.ConclusionThe real-time PCR test of pleural fluid specimens is a useful and non-invasive additional assay for fast diagnosis of pleural TB.

show abstract

Section: Introductionmentioning

confidence: 99%

Evaluation of real-time PCR of patient pleural effusion for diagnosis of tuberculosis

et al. 2011

View full text Add to dashboard Cite

show abstract

“…[ 6 ] Pleural fluid ADA was raised in 77% of our patients, out of which 93% patients were having TB as an etiology thus proving that determination of ADA levels has high accuracy in the diagnosis of the pleural TB and should be used as a routine test in its investigation. [ 7 ] Of the 42 patients whose pleural fluid for MGIT culture was done, positive growth was in 24% that had a better yield than Lowenstein–Jenson media which showed growth of TB bacilli in 9% patients. This finding correlates with a 2001 study by Luzze et al .…”

Section: Discussionmentioning

confidence: 99%

Clinical profile, etiology, and management of hydropneumothorax: An Indian experience

Kasargod

Awad

2016

Lung India

View full text Add to dashboard Cite

Introduction:Hydropneumothorax is an abnormal presence of air and fluid in the pleural space. Even though the knowledge of hydro-pneumothorax dates back to the days of ancient Greece, not many national or international literatures are documented.Aim:To study clinical presentation, etiological diagnosis, and management of the patients of hydropneumothorax.Materials and Methods:Patients admitted in a tertiary care hospital with diagnosis of hydropneumothorax between 2012 and 2014 were prospectively studied. Detailed history and clinical examination were recorded. Blood, pleural fluid, sputum investigations, and computed tomography (CT) thorax (if necessary) were done. Intercostal drainage (ICD) tube was inserted and patients were followed up till 3 months.Results:Fifty-seven patients were studied. Breathlessness, anorexia, weight loss, and cough were the most common symptoms. Tachypnea was present in 68.4% patients. Mean PaO2 was 71.7 mm of Hg (standard deviation ±12.4). Hypoxemia was present in 35 patients (61.4%). All patients had exudative effusion. Etiological diagnosis was possible in 35 patients by initial work-up and 22 required CT thorax for arriving at a diagnosis. Tuberculosis (TB) was etiology in 80.7% patients, acute bacterial infection in 14%, malignancy in 3.5%, and obstructive airway disease in 1.8%. All patients required ICD tube insertion. ICD was required for 24.8 days (±13.1).Conclusion:Most patients presented with symptoms and signs of cardiorespiratory distress along with cough, anorexia, and weight loss. Extensive pleural fluid analysis is essential in establishing etiological diagnosis. TB is the most common etiology. ICD for long duration with antimicrobial chemotherapy is the management.

show abstract

“…ADA >60 U/L has a sensitivity of more than 90% and a specificity of about 85% for the presence of tuberculosis. [ 19 20 ] In the presence of lymphocyte-predominant effusion, the specificity of ADA for tuberculosis increases to >95%. Thoracoscopy further confirmed the diagnosis of pleural tuberculosis in three cases.…”

Section: Discussionmentioning

confidence: 99%

A stepwise approach to the etiologic diagnosis of pleural effusion in respiratory intensive care unit and short-term evaluation of treatment

Chinchkar¹,

Talwar²,

Jain³

2015

Lung India

View full text Add to dashboard Cite

Background:Pleural effusions in respiratory intensive care unit (RICU) are associated with diseases of varied etiologies and often carry a grave prognosis. This prospective study was conducted to establish an etiologic diagnosis in a series of such patients before starting treatment.Materials and Methods:Fifty consecutive patients, diagnosed with pleural effusion on admission or during their stay in RICU, were further investigated by a two-step approach. (1) Etiologic diagnosis was established by sequential clinical history and findings on physical examination, laboratory tests, chest radiograph, CECT/HRCT/PET-CT and pleural fluid analysis. (2) Patients who remained undiagnosed were subjected to fiber-optic bronchoscopy, video-assisted thoracoscopic pleural biopsy, and histopathology.Results:Etiologic diagnosis of pleural effusion was established in 44 (88%) Metastases (24%); para-pneumonia (22%); congestive cardiac failure (18%); tuberculosis (14%); hemothorax (4%); trapped lung, renal failure, and liver cirrhosis (2% each). Six patients (12%) remained undiagnosed, as the final diagnostic thoracoscopic biopsy could not be performed in five and tissue histopathology findings were inconclusive in one. Out of the 50 patients, 10 died in the hospital; 2 left against medical advice; and 2 were referred to oncology center for further treatment. The remaining 36 patients were clinically stabilized and discharged. During a 3-month follow-up, eight of them were re-hospitalized, of which four died.Conclusions:Pleural effusion in RICU carries a high risk of mortality. Etiologic diagnosis can be established in most cases.

show abstract

Avaliação da adenosina desaminase no diagnóstico da tuberculose pleural: uma metanálise brasileira

Cited by 43 publications

References 21 publications

Evaluation of real-time PCR of patient pleural effusion for diagnosis of tuberculosis

Evaluation of real-time PCR of patient pleural effusion for diagnosis of tuberculosis

Clinical profile, etiology, and management of hydropneumothorax: An Indian experience

A stepwise approach to the etiologic diagnosis of pleural effusion in respiratory intensive care unit and short-term evaluation of treatment

Contact Info

Product

Resources

About