Diagnostic Efficacy of Pleural Fluid Adenosine Deaminase Level in diagnosing TB Pleural Effusion is Excellent in a High Prevalence Area.
Objectives: To evaluate the efficacy of Pleural Fluid ADA level in diagnosing tuberculous pleural effusions.
Place and Duration: The study was conducted at the Gulab Devi Chest Hospital Lahore from 03-01-2017 to 30-09-2017.
Methodology: 456 cases having age > 14 years and radiological evidence of pleural effusion were included. Patients having Age > 65 years, minimal inaspirable pleural effusion, negative consent for ADA estimation and with obvious radiological signs of malignancy were excluded. Detailed history, physical examination, radiological, haematological and biochemical findings were recorded. Pleural fluid analysis including ADA levels were recorded. Statistics was applied to reach the conclusion.
Results: 422/456(92.54%)cases were exudates while 34/456(7.45%) were transudate. 352 cases were diagnosed as TB pleuritis. 330(93.75%)cases showed PFADA levels 40 IU/L and above, while 22 cases showed ADA level < 40IU/L. Mean ADA level for TB peural effusion is 74.43IU/L. Using a cut off value 40 IU/L, we got a sensitivity of 93.75%, specificity 91.42 % and Positive predictive value 98.21% for tuberculosis.
Conclusion: Pleural fluid ADA level is a valuable bio-marker for TB diagnosis in an area of high prevalence. It successfully differentiates between tuberculous and non-tuberculous pleural effusion.
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.