Diagnostic utility of serum adenosine deaminase level in the diagnosis of pulmonary tuberculosis

Al-Aarag, Abdelsadek H.; Mohammad, Osama I.; Farag, Naglaa M

doi:10.4103/1687-8426.184369

Cited by 5 publications

(5 citation statements)

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“…The commonest pattern in this study was pattern B (66.34% cases) showing epithelioid granuloma with necrosis. The same was observed by Bhattacharya et al[18] and Khanna et al[19] in 69.4% and 50.5% cases, respectively.Results similar to our study were also demonstrated in the studies by Sulakshana et al[21], Ahmed et al[22], Abdelsadek et al[23], Mugulkod et al[15], and Stevanovic et al[3]. This was in contrast to the findings of Conde et al[22].…”

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confidence: 92%

Association of Serum Adenosine Deaminase Levels in Cytologically Suggested Cases of Tubercular Lymphadenitis: The Experience of a Tertiary Care Centre

et al. 2021

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Background: Tuberculosis (TB), a communicable disease, caused by Mycobacterium tuberculosis requires a simple, rapid test, which can be easily carried out in a laboratory. Unfortunately, despite a battery of investigations, no definite test is available till date. Adenosine deaminase (ADA), a biochemical marker has been proposed as a useful surrogate marker for TB as its levels can be measured in body fluids. Methods: A one-and-a-half-year prospective study of 154 cases presenting with lymphadenitis from January 2019 to June 2020 was undertaken. Using cytology, lymphadenitis subjects were divided into two groups: Tubercular (104 patients) as a case group and Reactive (50 patients) as a control group. All cases were followed by serum ADA assay by colorimetric method. Nonparametric tests were performed to compare the two groups. Results: The mean age of the participants was 28.99 ± 13.26 years with a F:M ratio of 1.81:1. Involvement of cervical lymph nodes was most frequent (89.42% cases). The mean S.ADA level for tubercular and reactive lymphadenitis was 41.71 ± 11.53 U/L and 21.16 ± 4.16 U/L, respectively (P-value < 0.05). The cut-off value calculated was 32.6 U/L. The sensitivity, specificity, PPV, NPV, and accuracy were calculated as 79.81%, 100%, 100%, 70.42%, and 86.36%, respectively. Conclusion: A statistically significant increase was found in serum ADA levels in tubercular lymphadenitis cases compared to reactive lymphadenitis. Hence, it can be used as an adjunct to FNAC and is a fairly sensitive and specific test. Since it is difficult to always demonstrate AFB in FNAC smears, ADA can be helpful in establishing a definite diagnosis despite smear negativity. Keywords: adenosine deaminase, lymphadenitis, tuberculosis

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confidence: 92%

Association of Serum Adenosine Deaminase Levels in Cytologically Suggested Cases of Tubercular Lymphadenitis: The Experience of a Tertiary Care Centre

et al. 2021

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“…In these circumstances, empirical anti-tuberculous therapy could be started. Therefore, finding some simple, accurate, and useful diagnostic methods for TB is very critical [4,15,16].…”

Section: Discussionmentioning

confidence: 99%

“…ADA is an enzyme that catalyzes adenosine to inosine for hydrolysis and deamination of deoxyadenosine to deoxyinosine. ADA concentration test in pleural fluid was used to diagnose pleurisy of TB [2,4,14]. The role of ADA in pulmonary TB diagnosis has been studied by Hassanein et al The study has included 20 sputum-positive acid-fast bacilli (AFB) patients, 10 bronchogenic carcinoma patients, 10 pneumonia patients, and 10 regular healthy subjects.…”

Section: Discussionmentioning

confidence: 99%

“…The activity of the ADA enzyme is increasing during lymphocyte mitogenic and antigenic responses and ADA inhibitors might inhibit T-lymphocyte blastogenesis [3]. ADA is now known to be a good marker of cell-mediated immunity, especially the activation of T-lymphocytes [4]. When any form of body fluid was tested for clear evidence of a disease, the positivity rate of, acid .fast bacilli (AFB) may be very .low, this culture phase is time consuming, costly, and requires a long incubation period that might take more than 4 weeks and less than 25% of its positivity percentage [3,4].…”

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confidence: 99%

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Diagnosis of Pulmonary and Extra-pulmonary Tuberculosis: Role of Adenosine Deaminase Levels in Different Body Fluids

.¹,

.²,

Ayous³

2021

amj

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Background: Tuberculosis (TB) is one of the major public health problems, particularly in developing countries. There are many tools to diagnose TB, one of them is the estimation of the level of adenosine deaminase (ADA) in various fluids in the body. Objectives: To find the role of ADA levels in 4 different types of body fluids to diagnose TB and extra-pulmonary TB. Materials and methods: This prospective study was conducted in the 3 main hospitals in Anbar governorate, Iraq for one year from July 2019 to June 2020. Four types of body fluids [serum samples, pleural fluid, ascetic fluid, and cerebrospinal fluid (CSF)] were collected from patients who were suspected of having TB. The levels of ADA were measured by ELISA. An accurate diagnosis of TB was done by Genexpert real-time polymerase reaction (PCR). The results were compared according to PCR findings.Results: Out of 176 patients, there were 31 patients were proved to be positive, for TB by Genexpert real-time PCR. The highest mean level of ADA in positive TB cases by PCR was in the pleural fluid (58.258 ± 2.707), and the last was in the serum. There was a highly statistically significant difference between the ADA levels in all 4 body fluids between the positive and negative TB cases (P-value= 0.000). In the positive cases, the sensitivity of ADA levels in the serum, CSF, pleural fluid, and ascetic fluid were found to be 40%, 81%, 96%, and 94% respectively and the specificity was found to be 88%, 72%, 94%, and 90% respectively. Conclusion: The ADA levels in all 4 body fluids were highly statistically significant difference between TB negative and positive cases diagnosed by PCR. However, they had different sensitivity and specificity levels.

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“…It is also involved in transformation of monocyte to macrophage. Tubercle bacilli stimulate T lymphocytes, which leads to [14][15][16][17][18][19] increase ADA concentration in pleural effusion.…”

Section: Table I: Pleural Fluid Ada Levels In Tuberculous and Non Tub...mentioning

confidence: 99%

Diagnostic Significance of Adenosine Deaminase and Lymphocytes in Suspected Tuberculous Pleural Effusion

Radhika

Naagar

2022

PIJR

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CONTEXT: Tuberculosis is a major public health problem in India. Tuberculous pleural effusion is a paucibacillary manifestation of the Tuberculosis, so isolation of Mycobacterium tuberculosis is difficult, biomarkers being an alternative for diagnosis. Pleural fluid Adenosine deaminase (ADA) level is being used in diagnosis of Tubercular pleural effusion. The combination of ADA and pleural fluid lymphocyte count is being recognized as a better method for increasing the specificity of ADA test. The present study was conducted to analyze the diagnostic usefulness ofAIM: ADA alone (≥ 40U/L) compared with the combination of ADA and pleural fluid lymphocyte count ( ≥ 50% ). SETTINGS AND DESIGN: METHODS AND MATERIAL:Retrospective study. Study was conducted for a period of one year from May 2017 to April 2018. A total of 110 pleural fluid samples data was analysed. SPSS 20STATISTICAL ANALYSIS USED: statistical software. ADA level in Tuberculous pleural effusion ranged from 40U/L to 112U/L with mean value ofRESULTS: 69.4U/L. Sensitivity, Specificity, Positive predictive valve (PPV) and Negative predictive values (NPV) for ADA alone were 93.2%, 76.4%, 82% and 90.6% respectively. For ADA and lymphocyte count the Specificity and PPV increased (98% and 98.1% respectively) with hardly any decrease in sensitivity or NPV (89.8% and 89.5% respectively). CONCLUSION: Combined use of ADA and pleural fluid lymphocyte count increases the specificity and PPV when compared to the specificity of ADA test alone in diagnosing Tubercular pleural effusion.

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Diagnostic utility of serum adenosine deaminase level in the diagnosis of pulmonary tuberculosis

Cited by 5 publications

References 6 publications

Association of Serum Adenosine Deaminase Levels in Cytologically Suggested Cases of Tubercular Lymphadenitis: The Experience of a Tertiary Care Centre

Association of Serum Adenosine Deaminase Levels in Cytologically Suggested Cases of Tubercular Lymphadenitis: The Experience of a Tertiary Care Centre

Diagnosis of Pulmonary and Extra-pulmonary Tuberculosis: Role of Adenosine Deaminase Levels in Different Body Fluids

Diagnostic Significance of Adenosine Deaminase and Lymphocytes in Suspected Tuberculous Pleural Effusion

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