SIGNIFICANCE OF ADENOSINE DEAMINASE LEVEL IN DIAGNOSIS OF TUBERCULOUS PLEURAL EFFUSION
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2017, Vol 6, Issue 75
Abstract
BACKGROUND Pleural effusion is a common chest problem, yet it is difficult to establish the aetiological diagnosis in as many as 20% cases in spite of good history, thorough clinical and radiological examination and pleural fluid analysis and pleural biopsy.1 There is a need of simple, rapid and reliable diagnostic test to establish the aetiology of pleural effusion. Many studies have investigated the usefulness of adenosine deaminase (ADA) in pleural fluid for the early diagnosis of tuberculous pleurisy. MATERIALS AND METHODS It was a time bound, hospital-based, case control study in the Department of Medicine, Downtown Hospital, Guwahati, Assam. All patients diagnosed with pleural effusion between Jan 2015 and Dec 2015 were studied; 30 patients were found to have tuberculous pleural effusion and 30 patients of non-tuberculous pleural effusion were taken for comparison. Pleural fluid ADA level was compared between tubercular and non-tubercular pleural effusion group and statistical analysis was done using SPSS software version 19. RESULTS A total of 60 patients of age > 18 years having pleural effusion were studied; 30 patients were in tubercular group and 30 patients were in non-tubercular pleural effusion group. Range of ADA in tuberculous group was 7 – 180 U/L with mean ± SD 84.99 + 45.45, while in non-tubercular group the range was 2 - 45.2 U/L with mean ± SD 13.52 + 9.95. We found a high significant (HS) difference in mean value of pleural fluid ADA level in each pair of groups when compared with tubercular group at .1% level of significance. At a cut-off of 40 U/L, the sensitivity and specificity of the test (pleural fluid ADA estimation for the diagnosis of tuberculosis) was 90.00% and 96.67% respectively, while the positive predictive value (PPV) and the negative predictive value (NPV) of the test was 96.43% and 90.62% respectively. CONCLUSION The method of ADA estimation is easy, simple and does not require expensive equipment. This test may find a place in routine investigation for early detection of TB in coming days and for differentiating tubercular from non-tubercular aetiology in pulmonary and extrapulmonary TB.
Authors and Affiliations
Manabendra Nayak, Sardhara Ashish Jayantibhai
Keywords
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- EP ID EP266607
- DOI 10.14260/Jemds/2017/1160
- Views 69
- Downloads 0
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