Adenosine deaminase activity in the diagnosis of tuberculous peritonitis.

Abstract

SUMMARY We studied the activity of adenosine deaminase in the peritoneal fluid of 66 patients who were divided into five groups according to causes of ascites as follows: tuberculous peritonitis (group I), septic peritonitis (group II), secondary to malignant tumours (group III), miscellaneous conditions (group IV), and control subjects of transudates (group V). In patients with tuberculous peritonitis the enzyme activity was significantly higher than for the rest of the groups (p<O-OO1), and enzyme concentrations in all patients were well above the upper non-tuberculous value. Adenosine deaminase activity in the peritoneal fluid has proved to be a simple and reliable method for early diagnosis of tuberculous peritonitis.Adenosine deaminase (EC 3.5.4.4) is an enzyme of the catabolism of purine bases, capable of catalysing the deamination of adenosine forming inosine in the process.1 Its principal biological activity is related to proliferation and differentiation of lymphocytes; the enzyme activity is greater in T lymphocytes than in B cells,2 4 and it is also inversely proportional to the degree of T cell differentiation.5 6In previous studies7-1 I we confirmed the high sensitivity and specificity of adenosine deaminase test for early diagnosis of tuberculous pleuropericardial and meningeal effusions. The adenosine deaminase increase was attributed to the maturative stage and/or degree of stimulation of T lymphocytes as a response of cell mediated immunity to mycobacterial antigens.This prospective report evaluates the adenosine deaminase test in patients with tuberculous peritonitis. Methods PATIENTSWe studied the activity of adenosine deaminase in the peritoneal fluid of 66 patients with ascites who

Role of ascitic fluid adenosine deaminase (ADA) and serum CA-125 in the diagnosis of tuberculous peritonitis

“…High level of ADA (cut off value 24 U/L) gave the test sensitivity of 93% and specificity 96%. [2][3][4] The CA-125 is a tumor marker associated with ovarian carcinoma. The CA-125 is also significantly higher in tuberculous peritonitis.…”

Cerebrospinal fluid Adenosine deaminase: its evaluation as a marker for diagnosing tuberculous meningitis in paediatric patients.

“…Elevated levels of ADA in CSF are not specific to meningeal inflammatory disease but it can be a test for confirming its etiology with good predictive value. Raised ADA levels have also been noted in other conditions particularly in certain intracranial tumors [16] . `…”

Adenosine Deaminase Assay in Different Body Fluids for the Diagnosis of Tubercular Infection

“…ADA assay has been reported as rapid and cost effective method which can be adopted in even primary healthcare settings in developing countries. Moreover, many studies have confirmed the high sensitivity and specificity of this assay for early diagnosis of extrapulmonary TB, such as tuberculous pleuritis, pericarditis and meningitis [13][14][15][16][17][18][19]. To our knowledge no study has been done in Bangladesh by comparing its efficacy with that of conventional methods as well as molecular techniques.…”

“…But requirement of dedicated laboratory areas, rigorous quality control and high cost of the test limits its routine use in resource poor countries. In this regard, adenosine deaminase (ADA) assay has shown to be a useful biochemical test in diagnosing TB from different body fluids, particularly in areas where the disease is prevalent [13][14][15][16][17][18][19].…”