Adenosine deaminase is a useful biomarker to diagnose pleural tuberculosis in low to medium prevalence settings

Michot, Jean‐Marie; Madec, Yoann; Bulifon, Sophie; Thorette-Tcherniak, Cécile; Fortineau, Nicolas; Noël, Nicolas; Lambotte, Olivier; Jahiri, Y. El; Delacour, Hervé; Delfraissy, Jean‐François; Blanc, François-Xavier

doi:10.1016/j.diagmicrobio.2015.11.007

Cited by 22 publications

(13 citation statements)

References 43 publications

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“…ADA might be increased in an attempt to maintain the clearance of the high levels of adenosine produced by a persistent inflammatory microenvironment and the increased activity of ecto‐nucleotidases . Several studies have shown the clinical use of ADA levels as a diagnostic and/or prognostic marker in various diseases with an important inflammatory component such as oral squamous cell carcinoma, chronic lymphocytic leukemia, tuberculosis, common chronic ears, nose and throat infections, Chagas disease, and leishmaniasis . The great difference in ADA levels between ovarian endometriomas and simple cysts found here suggests that ADA can also be a good biomarker for endometriosis.…”

Section: Discussionmentioning

confidence: 74%

Analysis of the ectoenzymes ADA, ALP, ENPP1, and ENPP3, in the contents of ovarian endometriomas as candidate biomarkers of endometriosis

Trapero

Jover

Fernández-Montolí

et al. 2017

American J Rep Immunol

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Section: Discussionmentioning

confidence: 74%

Analysis of the ectoenzymes ADA, ALP, ENPP1, and ENPP3, in the contents of ovarian endometriomas as candidate biomarkers of endometriosis

Trapero

Jover

Fernández-Montolí

et al. 2017

American J Rep Immunol

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“…The early diagnosis of TBP is essential to provide the appropriate initial treatment and reduce the mortality rate (Edwards et al, 2016). Unfortunately, conventional laboratory diagnostics, including smear microscopy and mycobacterial culture, fail to deliver satisfactory results for TBP (Michot et al, 2016). Laparoscopy-guided biopsy is used as an alternative for rapid TBP diagnosis (Bhargava et al, 1992), but the potential complications and infrastructure requirements hinder the application of this technique in resource-limited settings.…”

Section: Introductionmentioning

confidence: 99%

“…This test has been endorsed for the diagnosis of pulmonary TB and multiple forms of EPTB, except for TBP (World Health Organization, 2014). In addition, serial studies have demonstrated the use of adenosine deaminase (ADA) in the diagnosis of TB in various fluids, including pleural, meningeal, and pericardial (Michot et al, 2016;Riquelme et al, 2006;Voigt et al, 1989). However, the performance of ADA testing in peritoneal effusion (PE) remains controversial in view of the small sample sizes included in previous studies.…”

Section: Introductionmentioning

confidence: 99%

Multicenter evaluation of the acid-fast bacillus smear, mycobacterial culture, Xpert MTB/RIF assay, and adenosine deaminase for the diagnosis of tuberculous peritonitis in China

Liu

Li²,

Tan

et al. 2020

International Journal of Infectious Diseases

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Background: The aim of this study was to assess the validity of GeneXpert MTB/RIF (Xpert) and adenosine deaminase (ADA) in the diagnosis of tuberculous peritonitis (TBP). Methods: The laboratory results of peritoneal effusion (PE) specimens from patients with symptoms suggestive of TBP, attending three TB specialized hospitals between January 2016 and December 2018, were included retrospectively. Clinically diagnosed TBP was set as the gold standard to evaluate the performance of these methods. Results: In total, 191 individuals presenting with symptoms suggestive of TBP were included for analysis. The sensitivities of MGIT culture and Xpert were 17.2% and 18.3%, respectively. In addition, the TBP cases (69.8 AE 6.0 U/l) had higher amounts of ADA in their PE samples than the non-TBP cases (12.6 AE 1.6 U/l; p < 0.01). Using a threshold of 31.5 U/l to differentiate the TBP group from non-TBP group, the ADA assay provided a sensitivity of 89.6% and a specificity of 92.1%. The mean ADA concentration was significantly higher in bacteria-positive cases than in bacteria-negative cases (p < 0.01). Conclusions: In conclusion, the study data demonstrate the high sensitivity and specificity of the ADA test for the early diagnosis of TBP. In addition, the ADA concentration is directly correlated with the mycobacterial load.

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“…Meanwhile, the diagnostic utility of Adenosine deaminase activity (ADA) for PT continues to be controversial, but some recent publications support its use . It has been advocated as helpful in low‐to‐medium incidence settings , although not considered in the clinical guidelines of these countries . In contrast, it is included in guidelines for diagnosis of PT in high‐incidence Latin American countries .…”

Section: Introductionmentioning

confidence: 99%

Performance of clinical prediction rules for diagnosis of pleural tuberculosis in a high‐incidence setting

Solari

Soto

Stuyft

2017

Tropical Med Int Health

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View references (40)Objectives: Diagnosis of pleural tuberculosis (PT) is still a challenge, particularly in resource-constrained settings. Alternative diagnostic tools are needed. We aimed at evaluating the utility of Clinical Prediction Rules (CPRs) for diagnosis of pleural tuberculosis in Peru. Methods: We identified CPRs for diagnosis of PT through a structured literature search. CPRs using high-complexity tests, as defined by the FDA, were excluded. We applied the identified CPRs to patients with pleural exudates attending two third-level hospitals in Lima, Peru, a setting with high incidence of tuberculosis. Besides pleural fluid analysis, patients underwent closed pleural biopsy for reaching a final diagnosis through combining microbiological and histopathological criteria. We evaluated the performance of the CPRs against this composite reference standard using classic indicators of diagnostic test validity. Results: We found 15 eligible CPRs, of which 12 could be validated. Most included ADA, age, lymphocyte proportion and protein in pleural fluid as predictive findings. A total of 259 patients were included for their validation, of which 176 (67%) had PT and 50 (19%) malignant pleural effusion. The overall accuracy of the CPRs varied from 41% to 86%. Two had a positive likelihood ratio (LR) above 10, but none a negative LR below 0.1. ADA alone at a cut-off of ≥40 IU attained 87% diagnostic accuracy and had a positive LR of 6.6 and a negative LR of 0.2. Conclusion: Many CPRs for PT are available. In addition to ADA alone, none of them contributes significantly to diagnosis of PT.

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Adenosine deaminase is a useful biomarker to diagnose pleural tuberculosis in low to medium prevalence settings

Cited by 22 publications

References 43 publications

Analysis of the ectoenzymes ADA, ALP, ENPP1, and ENPP3, in the contents of ovarian endometriomas as candidate biomarkers of endometriosis

Analysis of the ectoenzymes ADA, ALP, ENPP1, and ENPP3, in the contents of ovarian endometriomas as candidate biomarkers of endometriosis

Multicenter evaluation of the acid-fast bacillus smear, mycobacterial culture, Xpert MTB/RIF assay, and adenosine deaminase for the diagnosis of tuberculous peritonitis in China

Performance of clinical prediction rules for diagnosis of pleural tuberculosis in a high‐incidence setting

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