USE OF ADENOSINE DEAMINASE  ACTIVITY IN PLEURAL FLUID FOR THE DIAGNOSIS OF TUBERCULAR PLEURAL EFFUSION.

DR. RADHIKA KRISHNASWAMY; PALLAVI R

Volume : V, Issue : IX, September - 2016

USE OF ADENOSINE DEAMINASE ACTIVITY IN PLEURAL FLUID FOR THE DIAGNOSIS OF TUBERCULAR PLEURAL EFFUSION.

Dr. Radhika Krishnaswamy, Pallavi R

Abstract :

Background Adenosine deaminase (ADA) activity is a quick non invasive method to diagnose of tubercular pleural effusion(TPE) compared to other methods which are less diagnostic and time consuming. A universal cut-off value for ADA in pleural fluid, is needed since results vary widely from country to country and even within a given region. The present study evaluated the effectiveness of the present cut-off point of (30 IU/L) in the diagnosis of TPE by determining the sensitivity and specificity and also evaluated the ability of the decreased cut off point 25 IU/L to improve the sensitivity and specificity and thereby the diagnostic accuracy. Materials&methods: ADA was estimated in pleural fluid specimens of 104 patients who were admitted for pleural effusion by the colorimetric procedure of Galanti and Guisti. Based on the cytological and radiological examination the patients were divided into Tubercular group and Non tubercular group with 50 and 54 subjects respectively. The cut-off value for positive ADA result was 30 U/L according to clinical practice at this hospital. Statistical analysis A Comparative correlation study of Adenosine deaminase levels in both groups was done based on Sensitivity/Specificity to diagnose the disease.. Results: The mean ADA level in Tubercular and in Non-tubercular group were 39.64 � 15.6IU/L and 13.17�11.40IU/L respectively with a P value <0.001** which is highly significant. The sensitivity, specificity was 74% and 90.74 respectively. Bringing down the cut-off value to 25 IU/L, the sensitivity improved from 74% to 84% which is significant and the specificity decreased to 89% from 90% which is not significant. Conclusion: The results of the present study it is suggested to ing down the cut-off value of Pleural Fluid ADA to 25 IU/L from 30IU/L to improve the efficiency of this test in diagnosing Tubercular pleural effusion.