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ADENOSINE DEAMINASE ANALYSIS IN TUBERCULOUS PLEURAL EFFUSION

VANITHA K KANDASAMY

Abstract


Tuberculosis is a major cause of pleural
effusion, in which pleural fluid usually has
lymphocytic and exudative characteristic.
Accurate and early diagnosis of tuberculous
pleurisy is essential for its correct
treatment and management in clinical
practice. Adenosine Deaminase is an enzyme
that increases in Tuberculosis (TB)
because of the stimulation of T cell lymphocytes
by mycobacterial antigens. The
current methods for the diagnosis of Tuberculosis
do not provide enough sensitivity
and specificity.Aims and objectives-Aim
of the study is to evaluate the ADA activity
in patients with tuberculous pleural effusion
and transudative pleural effusion and
to find out the diagnostic role in tuberculous
pleurisy. Materials and Methods-One
hundred cases admitted in the medical
ward on account of pleural effusion were
selected.As per Lights criteria cases are
classified in to exudate and transudate.
The final diagnosis was based on standard
diagnostic criteria. For TB pleural effusion,
the following criteria was adapted ctice.
to label as a case of Tuberculous effusion.
1. Bacteriological confirmation of presence
of Mycobacterium tuberculosis.
(direct smear or culture). 2. Radiological
finding consistent with tuberculosis exclusion
of other clinical consideration. 3.
Clinical presentation consistent with tuberculosis
(with exclusion). Group I includes
50 cases of Tuberculous pleural effusion
and Group II includes 50 cases of transudative
pleural effusion.ADA was estimated
in pleural fluid in both the groups. ADA
activity was measured in pleural fluid by
the Guisti and Glanti s method using semi
autoanalyser.Results- The mean and
standard deviation of ADA level in pleural
fluid was significantly high in group I
(102.86 plus or minus 22.61) when compared
to group II (16.48 plus or minus
3.02) and the p value was statistically significant.
Conclusion- Our study supports
the view that pleural fluid ADA estimation
is a very useful biomarker in establishing
an accurate diagnosis in tuberculous pleural
effusion. In addition it is a simple, rapid
and an inexpensive investigation that
could be a complimentary

test in the diagnostic workup of tuberculous
pleurisy in clinical pra


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