Study of Serum Adenosine Deaminase (ADA) Level in Diagnosis of Extrapulmonary and Smear Negative Tuberculosis

Badade ZG; Narshetty GS; Shah VK; Potdar PV; More K; Badade VZ

Volume : IV, Issue : XII, December - 2015

Study of Serum Adenosine Deaminase (ADA) Level in Diagnosis of Extrapulmonary and Smear Negative Tuberculosis

Badade Zg, Narshetty Gs, Shah Vk, Potdar Pv, More K, Badade Vz

Abstract :

Introduction: Tuberculosis is a major cause of morbidity and mortality throughout the world. One–third of the world�s population is infected with the TB, 5.2 million incident pulmonary TB patients notified globally in 2014. Only 3.0 million (58%) smear positive were bacteriologically confirmed, 42% of patients who were not bacteriologically confirmed were diagnosed clinically i.e. based on symptoms, chest X–Ray abnormalities or suggestive histologically and remains diagnostic challenge. In view of role of serum ADA in TB diagnosis this study was planned to investigate the diagnostic value of serum adenosine deaminase in diagnosis of extrapulmonary negative tuberculosis (EPTB) and pulmonary smear negative tuberculosis (SNPTB), because rapid and accurate diagnosis is an important element of TB treatment and control. Objective: To evaluate the diagnostic value and compare serum ADA activity in extra–pulmonary and pulmonary smear negative tuberculosis and to compare it with control. Method: Total of 120 volunteers was enrolled in the study after obtaining informed written consent. They were divided into 3 groups. Group I includes 40 healthy Individuals; Group II 40 patients newly diagnosed with extra–pulmonary TB and Group III 40 patients newly diagnosed with pulmonary smear negative TB. Serum ADA was estimation by modified GIUSTI method. Result: Serum ADA levels were significantly increased (p<0.001) in extrapulmonary TB (27.81 ± 7.034U/L) and Pulmonary Smear Negative TB (35.12 ± 12.1 U/L) as compared to control (14.603 ± 4.69U/L) with cut–off value 20 U/L. Conclusion: Moreover our study being cost effective, highly reliable, reproducible, simple to perform and less time consuming; in addition it helps in rapid and accurate diagnosis of EPTB and pulmonary smear negative tuberculosis, it can be included in routine diagnosis and prognosis of tuberculosis.