ADENOSINE DEAMINASE ANALYSIS IN TUBERCULOUS PLEURAL EFFUSION
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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PDFReferences
Richard W. Light Pleural diseases 5th
Edition 2007 by Lippincott Williams and
wilkinks chapter 1 page 3.
Anthony S.Fauci ,Dennis L. Kasper ,
Dan L.Longoetal , editors Harrisons principles
of internal medicine . volume 2 .
th edition. New york .McGraw Hill pub ;
page 2148,1348
Michael L . Bishop et al .6th Edition
pub by wolters Kluwer/ Lippincott
Williams and wilkinks page 601.
Waagner DC. The clinical presentation
of tuberculous diseases in children
.pediatr Ann 1993 ; 22(10) :622 –
.
Scharer L. Mclement JH. Isolation of
tubercule bacilli from needle biopsy
specimens of parietalpleura. Am Rev
Respir dis 1968: 97 (3):466 – 468 .
Shah S. Miller A, Mastellone A, et al
rapid Diagnosis of tuberculosis in various
biopsy and bodyfluid specimens
byAMPLICOR Mycobacterium tuberculosis
polymerase chain reaction test
Chest1998 ; 113 (5) : 1190 – 1194 .
AhemedS ,Fatema R et al (2011). Diagnostic
signostic of pleural fluid adenosine
deaminase activityin tuberculous
pleurisy. Ibrahim Medical College journal
(1)1-5
Yildiz PB, Yazar EE, et al (2011). Predictive
roll of adenosine deaminasefor
differential Diagnosis oftuberculosis and
malignant pleural effusion in turkey.
Asian pacific journal of cancer prevention
– 423.
Gecia – Monco JC CNS Tuberculosis.
Neurologic clinics. MarraC.Med : 1999 .
(4):737 – 60.
Nucleotide Metabolism, page
, Lippincott’s illustrated reviews
:biochemistry Pamela
C.Champe, Richard A Harvey et
al .4th edition pub by wolters Kluwer/
Lippincott Williams and wilkinks.
Kaya S. Cetin ES .Aridogam
BC, AridogamBC,Arikan S et al .
adenosinedeaminase activity in
serum of patients with hepatitis – a
useful tool in monitoring clinical
status . J Microbiolimmunol infect
; 40: 288 – 92.
Harshfield M.S: Mitchell B.S
immunodeficiency caused by
adenosine deaminase deficiency
and purine nucleoside phosphorylase
deficiency in :scriver , C . R
Beaudet ,A.L:Sly,W.SValle D. (eds)
.The metabolic and molecular basis
of inherited disease.
Tietz Text book of clinical chemistry
and molecular Diagnostics,
edited by Carl A. Buris Edward R.
Ashwood et al . , 4thed pub by
Saunders Elsevier.
J.P.JUngerer ,H.M.Oosthuizen
et al . Serum adenosine deaminase
:Isoenzymes and diagnostic
applications Clin. Chem .38/7,
– 1326 (1992).
Andrey V .Zavialov and
AkeEngstrom ,Human ADA2 belongs
to a new family of growth
factors with adenosine deaminase
activity , Biochem . J. (2005) 391,
– 57.
Hirschhorn R. Ratech H. Isozymes of
adenosine deaminase. Isozymescurr
T o p B i o l M e d R e s
9 8 0 ; 4 1 3 1 – 1 5 7
KatariaYP,Khurshid I . Adenosine
deaminase in the Diagnosis of tuberculosis
pleural effusionchest 2001; 120
(2):334 – 336.
Udwadia ZF and Sen T
(2010) .Pleural tuberculosis: an update.
Current Opinion in PulmonaryMedicine
399 – 406.
Jimenez castro , Light RW . et al. Di
agnostic value of adenosine deaminase
in nontuberculos lymphocytic pleural effusion.
EurRespir J 2003: 21(2) 220-224.
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