Diagnostic Value of Pleural Fluid Adenosine Deaminase in Tuberculous Pleuritis With Reference to HIV Coinfection and a Bayesian Analysis

Riantawan, Pratheep; Chaowalit, P; Wongsangiem, Manas; Rojanaraweewong, Prapant

doi:10.1378/chest.116.1.97

Cited by 87 publications

(77 citation statements)

References 17 publications

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“…Many studies have suggested that pleural fluid adenosine deaminase (pfADA) is useful in the diagnosis of tuberculous pleural effusion (TBPE). [3][4][5][6][7][8][9][10][11][12][13] The merits of using pfADA include its low cost, short turnaround time, and high sensitivity and specificity. 3,12 Notwithstanding possibly better sensitivity and specificity for detecting TBPE by combining ADA1 or ADA2 in pleural fluid (PF) with other PF biomarkers such as tumour necrosis factor-alpha, interleukin 27, interferon-gamma and dipeptidyl peptidase IV, [14][15][16][17] it may not be cost-effective to combine pfADA with other PF biomarkers.…”

Section: Introductionmentioning

confidence: 99%

Optimising the utility of pleural fluid adenosine deaminase for the diagnosis of adult tuberculous pleural effusion in Hong Kong

Chan²,

Leung

et al. 2017

Hong Kong Med J

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Section: Introductionmentioning

confidence: 99%

Optimising the utility of pleural fluid adenosine deaminase for the diagnosis of adult tuberculous pleural effusion in Hong Kong

Chan²,

Leung

et al. 2017

Hong Kong Med J

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“…With regards to the cut off level for ADA, Some large series suggest that a value >45 to 60 U/L is 100 percent sensitive and up to 97 percent specific for TPE. [15][16][17][18][19] Pleural effusions with an ADA level <40 U/L are rarely caused by TB. 20 Since this study was conducted in a resource limited setting, we wanted to increase the Specificity of the diagnosis of TPE and thus used ADA value of more than 60U/l as cut off.…”

Section: Resultsmentioning

confidence: 99%

“…16,17,28 Specificity is increased when the lymphocyte to neutrophil ratio is greater than 0.75 and the ADA is greater than 50 U/L. 25 False negatives and positive ADA results do occur, so ADA results need to be considered in the context of other features of the patient's clinical presentation.…”

Section: Resultsmentioning

confidence: 99%

Study of the Clinnical Characteristics and Outcomes of Exudative Pleural Effusion: Improving Clinical Decision Making in Resource Limited Setting

Mishra

Bhatta

Koirala

et al. 2017

SAARC J. Tuber. Lung Dis. HIV/AIDS

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Introduction: In the background of resource limited setting like Nepal, we set out to identify if specific clinical characteristics and basic lab parameters would guide differentiation of Tuberculous from other causes of exudative pleural effusion.Methodology: Retrospective study of 109 consecutive patients with exudative pleural effusion.Results: Compared to Tubercular pleural effusions (41.3%), increased age, increased duration of symptom and increased pack years statistically favoured a diagnosis of Malignant pleural effusion(21.1%), whereas presence of fever, cough and increased pleural ADA levels favoured Tubercular pleural effusions. With regards to Parapneumonic effusions (26.6%), a shorter duration of symptom, smaller effusions, higher pleural Neutrophils, lower pleural lymphocyte neutrophil ratio and lower ADA favoured the diagnosis as compared to Tubercular pleural effusions.Conclusions: The appreciation of important clinical and pleural biochemical differences between Tubercular and other major causes of exudative pleural effusions aids in improved clinical decision making with minimal resources in resource limited settings like ours.SAARC J TUBER LUNG DIS HIV/AIDS, 2017; XIV(1), page: 33-39

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“…(15) Um estudo recente revelou uma correlação entre a atividade da ADA e o alto número de células CD4 no líquido pleural de pacientes com TB, comparados a pacientes com câncer. (16) Em diferentes estudos de diagnóstico de derrame pleural, a ADA demonstrou sensibilidade de 90% a 100% e especificidade de 89% a 100%, quando se utilizou valor de corte maior que 40 U/l.…”

Section: Adenosina Deaminaseunclassified

“…Entretanto, a história clínica, a análi-se de imagem e a evolução clínica permitem que estes casos sejam mais facilmente discriminados. (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18) Com base nestas constatações, recomenda-se a pesquisa rotineira da ADA para o diagnóstico da tuberculose pleural.…”

Section: Adenosina Deaminaseunclassified

Tuberculose pleural

2006

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INTRODUÇÃOO comprometimento pleural representa a forma mais freqüente da tuberculose (TB) extrapulmonar. Freqüências variáveis são observadas em diferentes países, de acordo com a prevalência da TB e da sorologia positiva para o vírus da imunodeficiência humana (HIV).(1)A TB pleural pode ser uma manifestação tanto da forma primária da doença (primo-infecção) quanto da reativação de uma infecção latente pelo Mycobacterium tuberculosis. Em ambas a TB pleural está freqüentemente associada à forma pulmonar.(2) Nos países com alta prevalência, a TB ocorre mais em jovens como manifestação da TB primária, enquanto que nos países com baixa pre- RESUMOO derrame pleural tuberculoso pode ser devido a uma manifestação da forma primária da doença ou da reativação de uma infecção latente pelo M. tuberculosis. Os avanços nos métodos laboratoriais contribuíram sobremaneira para um melhor diagnóstico e para a compreensão da fisiopatologia desta doença. No entanto, embora o derrame pleural predominante linfocítico seja indicativo de tuberculose em nosso meio, uma rotina de abordagem diagnóstica deve ser instituída a fim de orientar o tratamento precoce e evitar seqüelas.Descritores: Tuberculose pleural/fisiopatologia; Derrame pleural/fisiopatologia; Tuberculose pleural/epidemiologia; Derrame pleural/epidemiologia; Biopsia ABSTRACTTuberculous pleural effusion is a common manifestation of the primary form of the disease or consequence of the reactivation of a latent infection due to the M. tuberculosis. Advances in the laboratory methods have contributed to better diagnose and understand the pathophysiology of the effusion secondary to tuberculosis. However, although a predominant lymphocytic pleural effusion is suspicious of tuberculosis, a diagnostic routine shall be instituted to orient treatment and prevent undesirable sequels.Keywords: Tuberculosis, pleural/physiopathology; Pleural effusion/physiopathology; Tuberculosis, pleural/epidemiology; Pleural effusion/epidemiology; Biopsy valência ela atinje mais a população idosa, como conseqüência da reativação de um foco de infecção latente, caracterizando a reativação endógena da doença. EPIDEMIOLOGIAEm todo o mundo, cerca de nove milhões de pessoas desenvolvem TB a cada ano. Aproximadamente 80% delas vivem em 22 diferentes países, sendo que o Brasil ocupa o 15º lugar, com cerca de 80 mil casos notificados a cada ano. Em alguns estados, a incidência da doença supera 100 casos por 100 mil habitantes. Além disto, há uma estimativa de 50 milhões de pessoas infectadas.

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Diagnostic Value of Pleural Fluid Adenosine Deaminase in Tuberculous Pleuritis With Reference to HIV Coinfection and a Bayesian Analysis

Cited by 87 publications

References 17 publications

Optimising the utility of pleural fluid adenosine deaminase for the diagnosis of adult tuberculous pleural effusion in Hong Kong

Optimising the utility of pleural fluid adenosine deaminase for the diagnosis of adult tuberculous pleural effusion in Hong Kong

Study of the Clinnical Characteristics and Outcomes of Exudative Pleural Effusion: Improving Clinical Decision Making in Resource Limited Setting

Tuberculose pleural

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