A Comparative Study and Evaluation of the Diagnostic Utility of Adenosine Deaminase (ADA) Activity in Pleural, Peritoneal and Cerebrospinal Fluid for the Diagnosis of Tuberculosis
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Abstract
Background
Tuberculosis is a major cause of effusion & meningitis. Diagnosis by conventional methods has either less sensitivity or time consuming. Detection of ADA enzyme activity has been proposed to be a useful surrogate marker for diagnosis of tuberculous effusion & TB meningitis.
Objective
To Assess the value of ADA activity in aspirated pleural, peritoneal and cerebrospinal fluid for the diagnosis of TB infection.
Methods
Total 150 fluid; 70 pleural, 16 peritoneal and 64 cerebrospinal fluid were evaluated for FDA activity along with routine biochemical, bacteriological and cytological examination. Findings are correlated with clinical and radiological, evidences. Results
Among confirmed 51 TB pleural effusion: ADA activity found positive >60 U/L) in 46 (90.2%) borderline (between 40 to 60 U/L) in 4. only 1 (1.96% was negative (<40 U/L). Among 2 TB peritoneal effusions: ADA activity found positive in both (100%). Among confirmed 21 TB meningitis cases: ADA activity found positive (> 10U/L) in 20(95.2%) and only 1(4.8%) was negative < 10 U/L).
Conclusion
Diagnosis of tuberculous effusion by direct smear, culture, cytology and biochemical tests have either limited sensitivity or specificity while test for biochemical marker-ADA activity is simple, rapid, and economic and has significant role in early diagnosis of tuberculous effusion and TB meningitis.
Tuberculosis is a major cause of effusion & meningitis. Diagnosis by conventional methods has either less sensitivity or time consuming. Detection of ADA enzyme activity has been proposed to be a useful surrogate marker for diagnosis of tuberculous effusion & TB meningitis.
Objective
To Assess the value of ADA activity in aspirated pleural, peritoneal and cerebrospinal fluid for the diagnosis of TB infection.
Methods
Total 150 fluid; 70 pleural, 16 peritoneal and 64 cerebrospinal fluid were evaluated for FDA activity along with routine biochemical, bacteriological and cytological examination. Findings are correlated with clinical and radiological, evidences. Results
Among confirmed 51 TB pleural effusion: ADA activity found positive >60 U/L) in 46 (90.2%) borderline (between 40 to 60 U/L) in 4. only 1 (1.96% was negative (<40 U/L). Among 2 TB peritoneal effusions: ADA activity found positive in both (100%). Among confirmed 21 TB meningitis cases: ADA activity found positive (> 10U/L) in 20(95.2%) and only 1(4.8%) was negative < 10 U/L).
Conclusion
Diagnosis of tuberculous effusion by direct smear, culture, cytology and biochemical tests have either limited sensitivity or specificity while test for biochemical marker-ADA activity is simple, rapid, and economic and has significant role in early diagnosis of tuberculous effusion and TB meningitis.