Comparative Study of Adenosine Deaminase Levels in Pleural Effusion of Tuberculous and Non Tuberculous Etiology; A Cross Sectional Study
DOI:
https://doi.org/10.48165/vbs5f617Keywords:
Tuberculosis, ADA, LDHAbstract
Background: Tuberculous pleural effusion (TPE) is very common in developing countries in comparison of developed countries; further TPE is one of the common characteristic of extra pulmonary tuberculosis. Adenosine deaminase (ADA) is an important enzyme which is found highly active in the diseases which induce cellular immunity. Therefore, the present study was designed to evaluate the accuracy of ADA level in the diagnosis of pleural effusion caused by tubercular etiology. Subjects and Methods: This was a cross-sectional type of study conducted at tertiary care institute. Total one hundred thirty five patients of pleural effusion were recruited for the study among them eighty nine pleural effusion patients were suffering with tuberculosis and forty six pleural effusion patients were without tuberculosis. A p-value < 0.05 was considered statistically significant. IBM SPSS Statistics 21 manufactured by IBM USA was used for entire calculations. Results: Findings of the present study have shown there was significant difference between ADA level of tubercular effusion patients (69.3±27.22) in comparison of non-tubercular pleural effusion patients (20.46±7.34). Further there was a significance difference between Lactate dehydrogenase (LDH) levels of the tubercular effusion patients (172.72±25.7) in comparison of non-tubercular pleural effusion patients (81.91±6356). However there was no significance difference between total protein (p>0.05), glucose level (p>0.05) and total cells (p>0.05) level of both groups. Conclusion: Finding of the present study showed that The ADA level was significantly high in pleural effusion patients with tubercular etiology in comparison of non-tubercular pleural effusion.
References
1. Light RW: Pleural Diseases. 5th edition. Philadelphia: Lippincott Williams & Wilkins; 2007.
2. Gopi A, Madhavan SM, Sharma SK, Sahn SA: Diagnosis and treatment of tuberculous pleural effusion in 2006. Chest 2007, 131:880–889.
3. Porcel JM (2009) Tuberculous pleural effusion. Lung 187: 263–270. 4. Udwadia ZF, Sen T (2010) Pleural tuberculosis: an update. Curr Opin Pulm Med 16: 399–406.
5. Baumann MH, Nolan R, Petrini M, Gary Lee YC, Light RW, et al (2007) Pleural tuberculosis in the United States: incidence and drug resistance. Chest 131: 1125–1132.
6. Light RW (2001) Pleural diseases. Baltimore: Lippincot, Williams and Wilkins. pp: 182–195.
7. Krenke R, Korczynski P (2010) Use of pleural fluid levels of adenosine deaminase and interferon gamma in the diagnosis of tuberculous pleuritis. Curr Opin Pulm Med 16: 367–375.
8. Singh R, Singh RK, Tripathi AK, Gupta N, Kumar A, Singh AK, et al. Circadian periodicity of plasma lipid peroxides and anti-oxidant enzymes in pulmonary tuberculosis. Indian J Clin Biochem 2004 Jan;19(1):14-20.
9. Harries AD. Tuberculosis and human immunodeficiency virus infection in developing countries. Lancet 1990 Feb;335(8686):387- 390.
10. Raviglione MC, O’Brien RJ. Tuberculosis. In. Fauci, Braunwald, Kasper, Hauser, Longo, Jameson, Loscalzo. Eds. Harrisons Principles of Internal Medicine, Tata McGraw Hill,17th ed. vol 1 p1010
11. Udwadia ZF, Sen T. Pleural tuberculosis: an update. Curr Opin Pulm Med 2010 Jul;16(4):399-406.
12. Bañales JL, et al (1991). Adenosine Deaminase in the diagnosis of Tuberculous Pleural Effusion. Chest 99:355-57
13. Ungerer JPJ, et al (1994). Significance of Adenosine Deaminase Activity and its Isoenzymes in Tuberculous effusions. Chest 106:33- 37.
14. Seibert AF, Haynes J Jr, Middleton R, Bass JB Jr, et al (1991). Tuberculous Pleural Effusion. Chest 99:883-86
15. Liang QL, Shi HZ, Wang K, Qin SM, Qin XJ (2008). Diagnostic accuracy of adenosine deaminase in tuberculous pleurisy: A meta analysis. Resp Med 102, 744–754.
16. Canbolat O, Ulusdoyuran S, Ozgun G, Ceyhan I, Gumuslu F, Akbay A. The comparison of adenosine deaminase activity value with polymerase chain reaction results in patients with tuberculosis. Journal of Clinical Laboratory Analysis 1999; 13: 209-212.
17. Riquelme A, Calvo M, Salech F, Valderama S, Pattiollo A, Arellano M, Arrese M, Soja A. Viviani P, Letelier LM, Value of adenosine deaminase (ADA) in ascitic fluid for the diagnosis of tuberculous peritonitis. J Clin Gastroenterol 2006; 8: 705-710.
18. Carstens ME, Burgess LJ, Maritz FJ, Taljaard JJF. Isoenxymes of adenosine deaminase in pleural effusion: a diagnostic tool? Int J Tuberc Lung Dis 1998; 10: 831-835.
19. Antony VB. Adenosine deaminase isoenzymes and pleural Tuberculousis. J Lab Clin Med., 1996; 127: 326-327.
20. Burgess LJ, Maritz FJ, Le Roux, et al. Combined used of pleural adenosine deaminase with lymphocyte/nentrophil ration: increased specificity for the diagnosis of tuberculous pleuritis. Chest, 1996; 109: 414-419.
21. ValdesL, San Jose E, Alvarez D, et al. Adenosine deaminase (ADA) isoenzyme analysis in plenral effusions; diagnostic role and relevance to the origin or increased ADENOSINE DEAMINASE in tuberculous pleurisy. Eur Respir J, 1996; 9: 747-751.
22. Bothamley GH. Tuberculous pleurisy and adnosine deaminase. Thorax, 1995; 50: 593-594.
23. Lima DM, Colares JKB and de Fonseca BAL. Combined used of the polymerase chain reaction and detection of adenosine deaminase activity on pleural fluid improves the rate of diagnosis of pleural tuberculosis. Chest 2003; 124: 909-914.
24. Reechaipichitkul W, Kawamatawong T,Teerajetgul Y,Patjanasoontorn B. Diagnostic role of pleural fluid adenosine deaminase in tuberculous pleural effusion. Southeast Asian J Trop Med Public health 2001; 32: 383-389.
25. Berger HW and Mejia E. Tuberculous pleurisy. Chest 1973; 63: 88-93. 26. Miserochi G, Agastoni E. Contents of the pleural space. J appl Physiol., 1971; 30: 208-213.
27. Leuallen EC, Carr DT. Pleural effusion, statistical study of 436 patients. N Eng J Med., 1955; 252: 79-83.
28. Paddock FK. The diagnostic significance of serous fluids in disease. N ENGL J Med., 1940; 223: 1010-1015.
29. Lee YCG, Light RW. Adenosine deaminase for lymphocytic pleural effusions. International pleural Newsletter, 2004; 25-6.
30. Valdes L. Alvarex D. San jose E, et al. Value of adenosine deaminase in the diagnosis of tuberculous pleural effusion in young patients in a region of high prevalence of Tuberculousis. Thorax, 1996; 50: 600- 603.
31. De Oliveira HG, Rossatto ER, Prolla JC. Pleural fluid adenosine deaminse and lymphocyte proportion: clinical usefulness in the diagnosis of Tuberculousis. Cutopathology, 1994; 5: 27-32.
