Diagnostic Efficacy of Pleural Fluid ADA, ICAM-1 and VCAM-1 to Differentiate Tubercular and Nontubercular Pleural Effusion
Journal Title: International Journal of Medical Research Professionals - Year 2018, Vol 4, Issue 2
Abstract
Background: Tuberculosis infection can occur in almost every organ in the body but involvement of lungs is most common. In extra pulmonary tuberculosis, tubercular pleural effusion is one of the commonest manifestations. The conventional culture suffers from lack of sensitivity. Various pleural fluid biochemical markers have been evaluated for diagnosis of tubercular pleural effusion but none of them was found to be ideal in terms of sensitivity, specificity and applicability. Materials and Methods: All consecutive patients with pleural effusion were subjected to thoracentesis and segregated into transudative and exudative using Light`s criteria. Patients with exudative pleural effusion were enrolled and divided into two groups. Group-I comprised of patients with tubercular etiology, Group-II- non-tubercular etiology. 66 patients with exudative effusion out of 87 patients screened were included. 30 patients were selected for each group as per group characteristics. Differential cell count, ADA, ICAM-1 and VCAM-1 in pleural fluid of these patients were measured. The sensitivity, specificity and predictive values were calculated. Results: A The sensitivity, specificity, positive predictive value, negative predictive value of Differential cell count, ADA ICAM-1 and VCAM-1 were 90.0%,80.0%,81.8% 88.9%,83.3%,90.0%, 89.3 %, 84.4 %, 80.0 %, 56.67 %, 64.90 %, 73.90%, 83.33 %, 80.0%, 80.6%, 82.8%, respectively. Combination of ADA with ICAM-1 and VCAM-1 improve the sensitivity or specificity compared to ICAM-1and VCAM-1 alone. Conclusion: Pleural fluid Differential cell count, ADA, ICAM-1 and VCAM-1 were found to be useful in differentiating tubercular from non-tubercular patients. Combination of ADA with ICAM-1 and VCAM-1 significantly improves the sensitivity and specificity.
Authors and Affiliations
Manoj Kumar, Sanjeev Kumar, Anita Sharma
Keywords
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- EP ID EP538062
- DOI 10.21276/ijmrp.2018.4.2.019
- Views 93
- Downloads 0
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