Original Research Article
Year: 2016 | Month: September | Volume: 3 | Issue: 9 | Pages: 35-39
Adenosine Deaminase (ADA): A Biochemical Marker for Diagnosis of Tubercular Pleural Effusion
Shikhaa Mahajan1*, Neeru Bhaskar2*, Suvarna Prasad3*,Sunita Manhas1*, K.S. Sodhi3*, Saurabh Gupta4**
1Assistant Professor, 2Professor and Head, 3Professor, 4Senior Resident,
*Department of Biochemistry. M.M.I.M.S.R, Mullana,Ambala, Haryana, India.
**Department of Radiology, Medanta the Medicity, Gurugram, Haryana, India.
Introduction: TB is a common cause of pleural effusion in countries like India where it is highly prevalent this study was designed to find out the role of ADA estimation in differentiation of TPE and non-TPE and to evaluate the diagnostic efficacy of ADA levels in TPE.
Materials and Methods: It was a hospital based study comprising of 73 patients, of either sex or age more than 20 years. They were divided into 2 groups: TPE and Non- TPE.
Results: Out of 73, 42 were TPE patients and 31 were Non-TPE patients. The mean age of 73 patients was 45.11 ± 15.71 years. Mean age of TPE patients was 43.69 ± 16.27 years and Non- TPE patients was 47.03 ±14.95 years. Mean ADA levels in all TPE patients was 68.362 ± 21.55 IU/L and in Non- TPE patients was 23.34 ± 7.54 IU/L, p<0.0001.The sensitivity and specificity of ADA was 100%.
Conclusion: ADA level of less than 40 IU/L virtually excludes the tubercular etiology in PE cases and thus may be useful in differentiating tuberculous etiology from other causes of PE. Although we have many methods for the diagnosis of TB, for example PCR, AFB staining and culture but these methods are costly, time consuming and do not provide enough sensitivity and specificity. Therefore, ADA estimation being a low cost, simple, rapid and non-invasive test should become an integral part of the diagnostic work up of PE in suspected cases of tuberculosis. As India has a high prevalence of TB and the sensitivity and specificity of this test is high in this population.
Key words: Tuberculosis (TB), Pleural effusion (PE), Adenosine deaminase (ADA.)