Role of adenosine deaminase in pleural fluid in tubercular pleural effusion

Modi, Suchita Dilip; Agrawal, Anil; Bhake, Arvind; Agrawal, Vikas R

doi:10.4103/jdmimsu.jdmimsu_77_17

Cited by 7 publications

(8 citation statements)

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“…In this study of 100 patients, 80 (80%) are males and 20(20%) females with sex ratio 4:1(M: F). The male predominance seen in our study (80%) is similar to studies done by Modi et al 1 (73.33%), Anushree Chakraborthy et al 8 (76%), Shubham Kumar Sharma et al 11 (78%) and Kate et al 9 (72%). Male predominance is nearer to the study done by Sharma et al The incidence of tuberculosis is more in males due to exposure to outdoor pollution, the presence of confounding factors like smoking, and migration to high prevalent areas.…”

Section: Discussionsupporting

confidence: 90%

“…An excessive collection of fluid in the pleural space is defined as Pleural effusion; it indicates an imbalance between pleural fluid formation and absorption. 1 According to the global TB report of the World Health Organization, a total of 10.0 million people were infected with the disease in 2018. India being in the high TB burden, accounts for 27% of the world's TB cases with an estimated 27.5 lakhs patients as per Global TB report 2018.…”

Section: Introductionmentioning

confidence: 99%

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Role of ADA and CBNAAT(Cartridge Based Nucleic Acid Amplification Test) in diagnosis of Tuberculosis in straw coloured exudative pleural effusion in patients attending Government General Hospital, KAKINADA

Srinidhi¹,

Mathangi²,

Kumar³

2020

IJIRM

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India is presently one of the high burden countries for tuberculosis and accounts for 23% of global TB burden with 2.2 million patients. Of these reported cases in India around 20% are of Extra Pulmonary Tuberculosis (EPTB).Pleural effusion due to TB is currently the second common location for EPTB next to TB lymphadenitis . The bacteriological confirmation to diagnose EPTB is more difficult due to its paucibacillary nature. The present study was done to determine the role of ADA and CBNAAT both being rapid and non-invasive diagnostic methods for early detection of tuberculous pleuritis, which is essential for treatment initiation, improved patient outcome and for more effective public health intervention. Materials and Methods: An observational study was done on 100 patients presenting with clinicoradiological picture suggestive of pleural effusion, either admitted or attending OPD of Department of Pulmonary Medicine from Nov 2017 to Nov 2019 at GGH, Kakinada. Results: Out of 100 exudative pleural effusions in study, male predominance with 80% of males and 20% females. Lymphocyte predominance is 74%, sputum AFB was positive in 6 cases. With ADA cut off as 40IU/L, 70 cases had an ADA > 40IU/L out of which 64 were tubercular, and 6 were malignant effusions .ADA has a sensitivity of 94% and specificity of 60%.Pleural fluid CBNAAT was positive in 30 cases, out of which 2 cases had an ADA < 40 IU/L .All are rifampicin sensitive. The sensitivity of CBNAAT is 40% and specificity 82%.There is a positive correlation between the lymphocyte predominance with ADA and CBNAAT with P<0.05%. Conclusion: Estimation of ADA in pleural fluid is a simple, rapid, and less expensive laboratory investigation where the diagnosis is uncertain. The sensitivity of ADA, when combined with lymphocytepredominant exudates, helps to diagnose tubercular effusions. The role of CBNAAT in diagnosing pleural TB is limited due to its poor sensitivity.

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Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Role of ADA and CBNAAT(Cartridge Based Nucleic Acid Amplification Test) in diagnosis of Tuberculosis in straw coloured exudative pleural effusion in patients attending Government General Hospital, KAKINADA

Srinidhi¹,

Mathangi²,

Kumar³

2020

IJIRM

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“…In this study, the majority of TB peritonitis and pleural TB patients started TB treatment based on the lymphocyte-predominant fluid analysis result. In accordance, a lymphocyte-predominant exudates [53][54][55] fluid of the pleura or peritoneum were also considered for the decision to start TB treatment in other developing countries. Since other illnesses especially intestinal carcinomatosis that revealed lymphocyte-predominant fluid analysis might mislead the diagnosis.…”

Section: Discussionmentioning

confidence: 99%

Epidemiology and the diagnostic challenge of extra-pulmonary tuberculosis in a teaching hospital in Ethiopia

et al. 2020

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Background Ethiopia reported a high rate of extra-pulmonary tuberculosis (EPTB) and the cases are increasing since the last three decades. However, diagnostic evidence to initiate TB treatment among EPTB cases is not well known. Therefore, we described the epidemiology and assessed how EPTB is diagnosed in a teaching hospital in Ethiopia. Methods We conducted a retrospective review among all adult EPTB cases diagnosed in Yekatit 12 Hospital Medical College from 2015 to 2019. Using a standardized data abstraction sheet, we collected data from patients’ medical records on sociodemographic, sites, and laboratory diagnosis of EPTB cases. Results Of the 965 total TB cases, 49.8%(481) had a recorded diagnosis of EPTB during the study period. The mean age of EPTB patients was 32.9 years (SD±13.9) and 50.7% were males. Tubercular lymphadenitis (40.3%), abdominal (23.4%), and pleural TB(13.5%) were the most common sites of EPTB involvement, followed in descending order by the genitourinary, skeletal, central nervous system, abscess, breast, and laryngeal TB. We found a histopathology finding consistent with EPTB in 59.1% of cases, Acid-fast bacilli positive in 1.5%, and the rest diagnosed on radiological grounds. In the majority of cases, more than one diagnostic method was used to diagnose EPTB cases. Conclusions Nearly half of TB patients had a recorded diagnosis of EPTB that comprise heterogeneous anatomical sites. All EPTB patients were started anti-TB therapy without definitive microbiology results. This indicates the diagnostic challenge of EPTB faced in our setting and proves to be significant for TB control in Ethiopia.

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“…In each case, thoracentesis provided a positive cytological finding [5]. Few of the related studies on lung diseases were reviewed [6][7][8][9]. Studies on pulmonary tuberculosis were reported by Dholkia et.…”

Section: Discussionmentioning

confidence: 99%

A Case Report on Pulmonary Effusion due to Non-Hodgkin’s Disease

Selsurkar

2021

JPRI

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Introduction: In patients with non- Hodgkin's disease, pleural effusion is not an unusual finding, with a recorded incidence of up to 20 percent. The effusion can be unilateral or bilateral, and the fluid causes symptoms of dyspnoea, cough, and/or chest pain in most patients. Case Presentation: A 17 years male was admitted in AVBRH with the chief complaint of chest pain since 4 days on one side which radiated to left shoulder, breathlessness from 2 days on walking and cough from 1 month. Patient had no complaint of fever, cold, abdominal pain, vomiting, orthopnia or trauma. The patient had done all necessary investigations by physician order. Therapeutic Intervention, Management and Outcomes: Patient was treated with oxygen therapy, chemotherapy, Thoracentesis and anticoagulant, antibiotics medication. Nursing Management: Administered fluid replacement i.e. RL, oxygen therapy 15 litres per minute, chemotherapy, monitored all vital signs half hourly. Conclusion: Timely treatment and management of Pleural effusion with non-Hodgkin’s disease can bring out successful recovery with limited complications.

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Role of adenosine deaminase in pleural fluid in tubercular pleural effusion

Cited by 7 publications

References 0 publications

Role of ADA and CBNAAT(Cartridge Based Nucleic Acid Amplification Test) in diagnosis of Tuberculosis in straw coloured exudative pleural effusion in patients attending Government General Hospital, KAKINADA

Role of ADA and CBNAAT(Cartridge Based Nucleic Acid Amplification Test) in diagnosis of Tuberculosis in straw coloured exudative pleural effusion in patients attending Government General Hospital, KAKINADA

Epidemiology and the diagnostic challenge of extra-pulmonary tuberculosis in a teaching hospital in Ethiopia

A Case Report on Pulmonary Effusion due to Non-Hodgkin’s Disease

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