Publication Type : Journal Article
Publisher : Lung India
Source : Lung India, 31(2):p 142-144, Apr–Jun 2014. DOI: 10.4103/0970-2113.129842
Url : https://journals.lww.com/lungindia/fulltext/2014/31020/diagnostic_utility_of_adenosine_deaminase_in.9.aspx
Campus : Kochi
School : School of Medicine
Department : Pulmonary Medicine
Year : 2014
Abstract : Objective:
To determine the diagnostic utility of adenosine deaminase (ADA) in exudative pleural effusions of different etiologies.
Setting and Design:
It was an observational study conducted at a tertiary care teaching institute.
Materials and Methods:
Of a total of 171 pleural fluid samples, 122 were found to be exudates and were included in the study. Pleural fluid ADA was done for all included patients. Pleural fluid ADA ≥40 U/l was taken as diagnostic cut off for TB effusion.
Statistical Analysis:
Sensitivity, specificity positive and negative predictive value of pleural fluid ADA for diagnosing TB was calculated by using clinical calculator – 1, Richard Lowry 2001-2013.
Results:
There were 171 patients with pleural effusion, out of which 122 (71.8%) were found to be exudative and were studied further. There were 49 (40.1%), 36 (29.5%) and 33 (27%) cases of TB, malignancy and para pneumonic effusion respectively, whereas 4 (3.3%) cases remained undiagnosed. Median ADA values for TB, malignancy and para pneumonic effusion were 55.8 U/l (range 9.7-756 U/l), 18 U/l (6.5-81 U/l) and 25 U/l (3.4-172 U/l) respectively. Pleural fluid ADA >40U/l yielded 85.7% sensitivity, 80.8% specificity, 75% positive predictive value and 89.5% negative predictive value.
Conclusion:
Pleural fluid ADA remains useful in diagnosing tuberculosis pleural effusion. The median ADA for TB effusion in present cohort was 51.8 IU/ml. Pleural fluid ADA of 40 U/L yielded 89.5% negative predictive value and 75% positive predictive value. Pleural fluid ADA is cost effective and good screening test for diagnosis of TB.
Cite this Research Publication : Mehta, Asmita A.; Gupta, Amit Satish; Ahmed, Subin; Rajesh, V., "Diagnostic utility of adenosine deaminase in exudative pleural effusions," Lung India, 31(2):p 142-144, Apr–Jun 2014. DOI: 10.4103/0970-2113.129842