Adenosine deaminase (ADA) level in tubercular pleural effusion

Verma, Swapna; Dubey, A L; Singh, Pooja; Tewerson, SL; Sharma, Devashish

doi:10.4103/0970-2113.44121

Cited by 33 publications

(26 citation statements)

References 8 publications

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“…In the present study, the mean value of ADA (38.8 IU/L) was significantly higher in cases of tuberculous pleurisy when compared to those of MPM, metastatic adenocarcinoma, chronic non specific pleurisy and septic empyema histopathological subgroups. This was in agreement with Verma et al [23] (>36 IU/L), Niwa et al [24] (>38 IU/L) and Rodriquiz [25] (>37 IU/L) who found higher levels of ADA in cases of tuberculous pleural effusion.…”

Section: Discussionsupporting

confidence: 93%

Diagnostic yield of medical thoracoscopy in diagnosis of exudative pleural effusion: One year prospective study

Mohamed

Shaban

2014

Egyptian Journal of Chest Diseases and Tuberculosis

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Background: Differential diagnosis of pleural disease is often a lengthy process fraught with pitfalls. Contrary to thoracocentesis and closed pleural biopsy, thoracoscopy permits biopsy with direct visualization. Medical thoracoscopy increases the diagnostic yield in patients with pleural disease when thoracocentesis and closed pleural biopsy are non diagnostic.Aim of the work: This study investigated diagnostic yield of medical thoracoscopy for undiagnosed exudative pleural effusions over one year period.Patient and Methods: This study included 117 patients with undiagnosed exudative pleural effusions. All patients were subjected to written informed consent, full history taking, clinical examination, plain chest X-ray, CT chest and tuberculin skin test. Diagnostic pleural aspiration was done with pleural fluid chemical and cytological analysis. Patients with unhelpful pleural fluid analysis underwent medical thoracoscopy.Results: Regarding thoracoscopic pleural biopsy histopathology, out of 117 patients, 55 were diagnosed as malignant pleural mesothelioma, 26 diagnosed as metastatic adenocarcinoma, 1 diagnosed as spindle cell carcinoma, 5 diagnosed as lymphoma, 5 diagnosed as tuberculosis, 1 diagnosed

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Section: Discussionsupporting

confidence: 93%

Diagnostic yield of medical thoracoscopy in diagnosis of exudative pleural effusion: One year prospective study

Mohamed

Shaban

2014

Egyptian Journal of Chest Diseases and Tuberculosis

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“…The south Khorasan and Zahedan in Iran, are among regions with relatively high prevalence of tuberculosis [13]. Despite some similarity in prevalence of TB among our region and Indian population, the mean pleural fluid ADA levels of our patients is reported to be lower than those from Indian population [6,[13][14][15]. Pleural fluid ADA levels in our patients were also reported lower than those from regions with low prevalence of tuberculosis such as Japanese and Albania and regions with intermediate prevalence of TB such as Portugal and Argentina [6,[16][17][18][19].…”

Section: Discussionmentioning

confidence: 90%

Pleural Fluid Adenosine Deaminase Values in Diagnosis of Tuberculous Pleural Effusion in South Khorasan Province

Mortazavi-Moghaddam

Sharifzadeh

Rezvani

2016

Zahedan J Res Med Sci

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Background: Due to variability of pleural fluid ADA measures in pleural tuberculosis, researchers have recommended the necessity of regional studies for determination of specific regional values. Objectives:The purpose of the present study was to evaluate the values of pleural fluid ADA in diagnosis of Tuberculous pleural effusion in South Khorasan province. Methods:A cross-sectional study was conducted on patients > 12 years old with exudative pleural effusion in South Khorasan province (east of Iran). Light criteria were used to define exudative effusion. Total ADA was determined calorimetrically by Diazyme ADA assay. The data were analyzed using t test, ANOVA and χ 2 tests through Spss 16 version software. Results:We studied 255 cases including 139 (54.5%) males and 116 (45.5%) females with mean age of 63.8 ± 18 years. There were 36 (14.1%) cases with Tuberculous pleural effusion and 219 (85.9%) cases of non-Tuberculous pleural effusion. Malignant and acute bacterial infection comprise 106 (41.6%) and 29 cases (11.4%), respectively. The mean levels and optimal cut off point of ADA in Tuberculous pleural effusion were40.2 ± 24.7 and 30 IU/L respectively. ADA in Tuberculous pleural effusion showed negative correlation with age (r = -0.40, p = 0.01), but weak positive correlation with fluid protein(r = 0.44, P = 0.007) and LDH (r = 0.32, P = 05). Conclusions:Mean and cut off point of ADA was relatively low in patients with Tuberculous pleural effusion in South Khorasan province. The age of patients and fluid levels of protein, and LDH must be considered in interpretation of pleural fluid ADA levels.

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“…A study by SK Verma et al also found ADA levels in malignant PE ranging from 18.5 to 87.6U/L. 15 In another study by D Jimenez Castro et al on ADA levels in non tuberculous pleural effusion, a negative predictive value of 99% was reported for diagnosis of non tuberculous pleural effusion and the ratio of ADA1/ADA2 correctly classified all the cases as non tuberculous pleural effusion. 16 ADA exists in two isoenzyme forms, ADA1 is expressed in all cells where as ADA2 is found only in monocytes.…”

Section: Discussionmentioning

confidence: 97%

Efficacy of Pleural Fluid Adenosine Deaminase and C-Reactive Protein Levels in Early Differential Diagnosis of Pleural Effusion.

Nusrath¹,

M²,

Rajeshwari³

et al. 2013

jemds

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-CONTEXT: Pleural effusion occurs secondary to various diseases. Common causes of exudative effusion are tuberculosis, bacterial pneumonia, and malignancy. Transudative effusion is due to systemic diseases like cardiac failure, cirrhosis of liver. Conventional methods of diagnosis may not be able to establish the cause of pleural effusion. Early diagnosis and management reduces the morbidity and mortality.AIM: The objective of the study is to estimate pleural fluid Adenosine Deaminase (ADA) and C -reactive protein (CRP) levels and to evaluate their efficacy in differential diagnosis of transudative and exudative, tuberculous and non tuberculous and inflammatory and non inflammatory effusions. MATERIAL AND METHODS: Fifty two patients of pleural effusion were investigated and divided into four groups based on diagnosis. Group I, II, III and IV had 24 cases of tuberculous effusion, 13 cases of transudative effusion, 08 cases of malignant effusion and 07 cases of parapneumonic effusion respectively. Pleural fluid was analyzed for ADA (Guisti and Galanti's method) and CRP (turbidometric immunoassay).STATISTICAL ANALYSIS: The statistical analysis was done using unpaired student't' test and p value < 0.05 was considered statistically significant. RESULTS: In the present study pleural fluid ADA revealed highly significant increase in tuberculous effusion than non tuberculous effusions (p <0.001) and also when compared with non tuberculous subgroups, transudative effusion (p < 0.001), malignant effusion (p<0.001), and PPE (p<0.01). ADA levels at a cutoff value of 40U/L, showed sensitivity, specificity, positive predictive value and negative predictive value of 91.67%, 89.3%, 88% & 92.6% respectively in tuberculous effusion. Pleural fluid CRP levels in parapneumonic effusion were significantly higher compared to other types of effusions (p<0.001). Significantly higher levels of CRP were seen in exudative effusion compared to transudative effusion (p<0.001) and in inflammatory effusion compared to non inflammatory effusion (p<0.001). ORIGINAL ARTICLEJournal of Evolution of Medical and Dental Sciences/ Volume 2/ Issue 22/ June 3, 2013Page 3988 CONCLUSIONS: Pleural fluid ADA is sensitive test in discriminating tuberculous and non tuberculous effusions. Pleural fluid CRP levels distinguish transudative from exudative effusion, inflammatory from non inflammatory effusion. ADA and CRP assays are rapid, minimally invasive and cost effective and measurement of these two parameters increases the efficacy of diagnosing pleural effusion. KEY WORDS: Adenosine deaminase, C -reactive protein, Pleural effusion. INTRODUCTION:Pleural effusion (PE) is a common complication associated with number of diseases. Accumulation of pleural fluid may be due to various causes such as increased pleural membrane permeability, increased capillary pressure, decreased oncotic pressure and lymphatic obstruction. 1 Transudative pleural effusions occur when systemic factors which effect the formation and absorption of pleural fluid are altered. Ex...

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Adenosine deaminase (ADA) level in tubercular pleural effusion

Cited by 33 publications

References 8 publications

Diagnostic yield of medical thoracoscopy in diagnosis of exudative pleural effusion: One year prospective study

Diagnostic yield of medical thoracoscopy in diagnosis of exudative pleural effusion: One year prospective study

Pleural Fluid Adenosine Deaminase Values in Diagnosis of Tuberculous Pleural Effusion in South Khorasan Province

Efficacy of Pleural Fluid Adenosine Deaminase and C-Reactive Protein Levels in Early Differential Diagnosis of Pleural Effusion.

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