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Year : 2018  |  Volume : 13  |  Issue : 4  |  Page : 163-167

Role of adenosine deaminase in pleural fluid in tubercular pleural effusion

1 Department of Pathology, JNMC, Wardha, Maharashtra, India
2 Department of Surgery, JNMC, Wardha, Maharashtra, India

Correspondence Address:
Dr. Suchita Dilip Modi
Department of Pathology, JNMC, Sawangi (Meghe), Wardha, Maharashtra
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jdmimsu.jdmimsu_77_17

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Background: Each year approximately 1 million patients develop the pleural effusion. Tuberculosis (TB), the single most frequent infectious cause of death worldwide, also is one of the leading causes of pleural effusion. Despite the advent of novel improvements in the diagnosis and treatment of pulmonary TB, a definite diagnosis of TB in a significant number of patients is problematic. Measurement of the level of adenosine deaminase (ADA) enzyme in body fluids is a helpful diagnostic tool. The level of ADA elevates as the lymphocyte (T-cell) activity increases. The present study was carried out to evaluate the ADA activity in pleural fluid for early diagnosis and management of tubercular pleural effusion (TPE). Objectives: The main objective is to determine the tubercular pleural fluid ADA level and its sensitivity and specificity. Materials and Methods: The prospective analytical study was conducted at Acharya Vinobha Bhave Rural Hospital, Sawangi (Meghe), in 105 patients of suspected case of TPE. A structured proforma was used for documenting the history, symptoms, side of effusion, hemogram and erythrocyte sedimentation rate (ESR), pleural fluid findings which included pH, glucose, proteins, lactate dehydrogenase (LDH), total leukocyte count (TLC) and differential leukocyte counts and serum ADA level was also calculated. Results: ADA sensitivity, specificity, positive predictive value, and negative predictive value (NPV) are 89.47%, 48.28%, 81.93%, and 63.65%, respectively, for TB. Pleural fluid ADA activity has been shown to be a valuable biochemical marker that has a high sensitivity for TB diagnosis. Conclusion: Pleural fluid ADA is markedly raised in tubercular effusions. ADA estimation is a simple, reliable, cost-efficient, and diagnostically useful investigation.

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